Organization · Type 2 NPI

Dva Healthcare of Tuscaloosa LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Eutaw, AL

NPI number 1336112143 Active

Practice location

544 US Highway 43
Eutaw, AL 35462-4017

Call (205) 372-4000 Map

Fax (205) 372-4055

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	S3201 (AL)

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

NPI record

NPI: 1336112143
Entity type: Organization (Type 2)
Issued: Feb 10, 2006
Last updated: Sep 26, 2024
Status: Active

Other names

<unavail>
Greene County Dialysis · doing business as
Greene County Dialysis · doing business as

Authorized official

Samuel T Wey
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 1336112143

Dva Healthcare of Tuscaloosa LLC's National Provider Identifier is 1336112143, issued on Feb 10, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Eutaw, AL. The record was last updated on Sep 26, 2024.