Organization · Type 2 NPI

Dva Healthcare Renal Care Inc

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Charlotte, NC

NPI number 1720047301 Active

Practice location

10504 Park Rd
Charlotte, NC 28210-8405

Call (980) 399-4784 Map

Fax (980) 399-4817

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	None listed

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

2 other providers at this address

Charlotte Pain Associates PAPain Medicine (Anesthesiology) Physician Charlotte, NC NPI 1760475537
Nead Medical Pc.Ambulatory Surgical Clinic/Center Charlotte, NC NPI 1508182361

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NPI record

NPI: 1720047301
Entity type: Organization (Type 2)
Issued: Mar 21, 2006
Last updated: Jan 23, 2024
Status: Active

Other names

<unavail>
South Charlotte Dialysis · doing business as
South Charlotte 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 1720047301

Dva Healthcare Renal Care Inc's National Provider Identifier is 1720047301, issued on Mar 21, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Charlotte, NC. The record was last updated on Jan 23, 2024.