Organization
DVA RENAL HEALTHCARE, INC.
Active
Other names
Tallahassee South Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
2410 S ADAMS ST, TALLAHASSEE, FL 32301-6325
(850) 224-8757
(850) 224-8766
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000893153C
—
GA
05
—
890033700
—
FL
Enumeration date
03/11/2006
Last updated
03/12/2026
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