Organization · Type 2 NPI

Dva Healthcare Renal Care Inc

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Brunswick, GA

NPI number 1104895143 Active

Practice location

53 Scranton Connector
Brunswick, GA 31525-1862

Call (912) 264-8657 Map

Fax (912) 265-6542

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	ESRD001131 (GA)

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

Another provider at this address

Davita DialysisEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center Brunswick, GA NPI 1730231382

Other end-stage renal disease (esrd) treatment clinic/center providers in Brunswick

See all in Brunswick →

NPI record

NPI: 1104895143
Entity type: Organization (Type 2)
Issued: Mar 14, 2006
Last updated: Aug 7, 2025
Status: Active

Other names

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

Authorized official

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

Verify this record

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 1104895143

Dva Healthcare Renal Care Inc's National Provider Identifier is 1104895143, issued on Mar 14, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Brunswick, GA. The record was last updated on Aug 7, 2025.