Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Omaha Central Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
144 S 40TH ST, OMAHA, NE 68131-3004
(402) 558-0818
(402) 558-2286
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4514
(866) 594-9961
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD025
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0546705
—
IA
01
—
187
MO KIDNEY CARE PROGRAM
MO
Enumeration date
04/03/2006
Last updated
10/01/2020
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