Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Fresno Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T. WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
4308 W SHAW AVE STE 101, FRESNO, CA 93722-6218
(559) 277-3070
(559) 276-4261
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
240000782
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851365852
—
CA
Enumeration date
02/15/2006
Last updated
05/06/2026
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