Organization
DVA HEALTHCARE OF MASSACHUSETTS INC
Active
Other names
Wellington Circle Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
10 CABOT RD, STE 103B, MEDFORD, MA 02155-5275
(781) 306-9740
(781) 306-9745
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
EQ1D
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110028113J
—
MA
Enumeration date
03/20/2006
Last updated
03/07/2025
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