Organization
DAVITA TIDEWATER LLC
Active
Other names
Leigh Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER (CHIEF ACCOUNTING OFFICER)
(253) 733-4500
Entity
Organization
Contact information
Practice address
420 N CENTER DR, BLDG 11-STE128, NORFOLK, VA 23502-4007
(757) 455-0060
(757) 455-0065
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, BRENTWOOD, TN 37027-7569
(615) 341-5875
(888) 563-4087
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
—
1952365082
—
VA
Enumeration date
04/14/2006
Last updated
09/22/2015
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