Organization
DVA HEALTHCARE OF MASSACHUSETTS INC
Active
Other names
New Bedford 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
237-B STATE RD, NORTH DARTMOUTH, MA 02747-2612
(508) 992-0629
(508) 999-1319
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4214
(866) 944-3352
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
EHKF
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1311379
—
MA
05
—
4102530
—
RI
Enumeration date
03/20/2006
Last updated
03/27/2024
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