Organization · Type 2 NPI
Dva Healthcare Renal Care Inc
End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Lucedale, MS
NPI number
1629039086
Active
Practice location
652 Manila St
Lucedale, MS 39452-5962
Fax (601) 947-8980
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...
About NPI 1629039086
Dva Healthcare Renal Care Inc's National Provider Identifier is 1629039086, issued on Mar 28, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Lucedale, MS. The record was last updated on Nov 10, 2025.