Organization · Type 2 NPI

Dva Renal Healthcare Inc

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Cookeville, TN

NPI number 1023070653 Active

Practice location

320 N Willow Ave
Cookeville, TN 38501-2337

Call (931) 520-7763 Map

Fax (931) 646-4866

Mailing address

5200 Virginia Way, L&c Department
Brentwood, TN 37027-7569

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	110 (TN)

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

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NPI record

NPI: 1023070653
Entity type: Organization (Type 2)
Issued: Apr 6, 2006
Last updated: Apr 28, 2025
Status: Active

Other names

<unavail>
Cookeville Dialysis · doing business as
Cookeville Dialysis · doing business as

Authorized official

Samuel T Wey
VP Licensure & Certification
(615) 341-6641

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1023070653

Dva Renal Healthcare Inc's National Provider Identifier is 1023070653, issued on Apr 6, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Cookeville, TN. The record was last updated on Apr 28, 2025.