Organization · Type 2 NPI

Dva Healthcare Southwest Ohio LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Fairfield, OH

NPI number 1720042096 Active

Practice location

1210 Hicks Blvd
Fairfield, OH 45014-1921

Call (513) 939-1110 Map

Fax (513) 939-1202

Mailing address

5200 Virginia Way, Att: L&c Dept
Brentwood, TN 37027-7569

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	0491DC (OH)

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

5 other providers at this address

Bullock Dialysis LLCEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center Fairfield, OH NPI 1477018810
Dva Renal Healthcare IncEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center Fairfield, OH NPI 1184688459
Frank J. Albers, MDNephrology Physician Fairfield, OH NPI 1598708612
Sara Atallah, MDNephrology Physician Fairfield, OH NPI 1598170763
Sharad Goel, MDNephrology Physician Fairfield, OH NPI 1861438657

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

See all in Fairfield →

NPI record

NPI: 1720042096
Entity type: Organization (Type 2)
Issued: Apr 13, 2006
Last updated: Aug 18, 2026
Status: Active

Other names

<unavail>
Fairfield Dialysis · doing business as
Fairfield 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 1720042096

Dva Healthcare Southwest Ohio LLC's National Provider Identifier is 1720042096, issued on Apr 13, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Fairfield, OH. The record was last updated on Aug 18, 2026.