Organization · Type 2 NPI

Dva Healthcare of Massachusetts Inc

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Medford, MA

NPI number 1205415593 Active

Practice location

712 Fellsway
Medford, MA 02115

Call (781) 957-4032 Map

Fax (781) 957-4050

Mailing address

5200 Virginia Way, L And 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: 1205415593
Entity type: Organization (Type 2)
Issued: Apr 5, 2021
Last updated: Apr 7, 2025
Status: Active
Subpart: Yes of Davita Inc

Other names

<unavail>
Mystic River Home Training · doing business as
Mystic River Home Training · doing business as

Authorized official

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

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About NPI 1205415593

Dva Healthcare of Massachusetts Inc's National Provider Identifier is 1205415593, issued on Apr 5, 2021. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Medford, MA. The record was last updated on Apr 7, 2025.