Organization · Type 2 NPI

Dva Healthcare Renal Care Inc

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Gonzales, LA

NPI number 1760441802 Active

Practice location

1125 S Burnside Ave
Gonzales, LA 70737-4248

Call (225) 255-4070 Map

Fax (225) 255-4071

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	026 (LA)

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

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NPI record

NPI: 1760441802
Entity type: Organization (Type 2)
Issued: Mar 18, 2006
Last updated: Sep 8, 2025
Status: Active

Other names

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

Authorized official

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

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About NPI 1760441802

Dva Healthcare Renal Care Inc's National Provider Identifier is 1760441802, issued on Mar 18, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Gonzales, LA. The record was last updated on Sep 8, 2025.