Organization · Type 2 NPI

Dva Renal Healthcare Inc

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Mount Olive, NC

NPI number 1205895976 Active

Practice location

105 Michael Martin Rd
Mount Olive, NC 28365-1112

Call (919) 658-0878 Map

Fax (919) 658-0873

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...

NPI record

NPI: 1205895976
Entity type: Organization (Type 2)
Issued: Mar 21, 2006
Last updated: Sep 19, 2025
Status: Active

Other names

<unavail>
MT Olive Dialysis · doing business as
MT Olive Dialysis · doing business as

Authorized official

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

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About NPI 1205895976

Dva Renal Healthcare Inc's National Provider Identifier is 1205895976, issued on Mar 21, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Mount Olive, NC. The record was last updated on Sep 19, 2025.