Organization · Type 2 NPI

Dva Healthcare Renal Care Inc

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Oklahoma City, OK

NPI number 1124080486 Active

Practice location

319 SW 59th St
Oklahoma City, OK 73109-8301

Call (405) 634-3708 Map

Fax (405) 636-1211

Mailing address

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

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	None listed

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

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NPI record

NPI: 1124080486
Entity type: Organization (Type 2)
Issued: Apr 3, 2006
Last updated: Dec 19, 2024
Status: Active

Other names

<unavail>
Oklahoma City South Dialysis · doing business as
Oklahoma City South 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 1124080486

Dva Healthcare Renal Care Inc's National Provider Identifier is 1124080486, issued on Apr 3, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Oklahoma City, OK. The record was last updated on Dec 19, 2024.