Organization · Type 2 NPI

Dva Renal Healthcare Inc

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

NPI number 1316916356 Active

Practice location

539 Fair St
Baxley, GA 31513-0112

Call (912) 366-0202 Map

Fax (912) 366-0333

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	ESRD001055 (GA)

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

NPI record

NPI: 1316916356
Entity type: Organization (Type 2)
Issued: Mar 14, 2006
Last updated: May 30, 2024
Status: Active

Other names

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

Authorized official

Samuel 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 1316916356

Dva Renal Healthcare Inc's National Provider Identifier is 1316916356, 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 Baxley, GA. The record was last updated on May 30, 2024.