Dva Healthcare Renal Care INC
Clinic/Center, End-Stage Renal Disease (ESRD) Treatment in Oklahoma City, OK. Organization (NPI-2).
NPI number1124080486
StatusActive
Last updated in NPPESDec 19, 2024
Details
- NPI
- 1124080486
- Entity type
- Organization (NPI-2)
- Legal business name
- Dva Healthcare Renal Care INC
- Organization subpart
- No
- Enumeration date
- Apr 3, 2006
- Certification date
- Dec 19, 2024
- Last updated
- Dec 19, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | – | – | Yes |
Other names
- Oklahoma City South Dialysis (Doing Business As)
Practice location
319 Sw 59th StOklahoma City, OK 73109-8301
Phone 405-634-3708 · Fax 405-636-1211
Mailing address
5200 Virginia WayL&C Dept
Brentwood, TN 37027-7569
Authorized official
Samuel T Wey
Vp Licensure & Certification
6153416641
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