Organization · Type 2 NPI

Dva Renal Healthcare Inc

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

NPI number 1376511550 Active

Practice location

190 Westside Dr Ste A
Douglas, GA 31533-3534

Call (912) 384-3439 Map

Fax (912) 383-6324

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	ESRD001018 (GA)

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

Other end-stage renal disease (esrd) treatment clinic/center providers in Douglas

Renal Treatment Centers - Mid-Atlantic, Inc.End-Stage Renal Disease (ESRD) Treatment Clinic/Center Douglas, GA NPI 1316616519

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NPI record

NPI: 1376511550
Entity type: Organization (Type 2)
Issued: Mar 14, 2006
Last updated: Mar 12, 2025
Status: Active

Other names

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

Authorized official

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

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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 1376511550

Dva Renal Healthcare Inc's National Provider Identifier is 1376511550, 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 Douglas, GA. The record was last updated on Mar 12, 2025.