Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Catonsville North Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (SR DIRECTOR LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
5401 BALTIMORE NATIONAL PIKE, BALTIMORE, MD 21229-2102
(410) 869-4618
(410) 869-4704
Mailing address
5200 VIRGINIA WAY, 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
E2634
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
402822800
—
MD
05
—
PENDING
—
DC
Enumeration date
03/24/2006
Last updated
08/08/2023
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