Organization · Type 2 NPI
Dva Renal Healthcare Inc
End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Jacksonville, IL
NPI number
1316916513
Active
Practice location
1515 W Walnut St
Jacksonville, IL 62650-1150
Fax (217) 243-1365
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 | None listed |
End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...
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About NPI 1316916513
Dva Renal Healthcare Inc's National Provider Identifier is 1316916513, issued on Mar 17, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Jacksonville, IL. The record was last updated on Oct 4, 2024.