Dva Healthcare Renal Care INC
Clinic/Center, End-Stage Renal Disease (ESRD) Treatment in Bakersfield, CA. Organization (NPI-2).
NPI number1366416273
StatusActive
Last updated in NPPESJan 18, 2024
Details
- NPI
- 1366416273
- Entity type
- Organization (NPI-2)
- Legal business name
- Dva Healthcare Renal Care INC
- Organization subpart
- No
- Enumeration date
- Feb 15, 2006
- Certification date
- Jan 18, 2024
- Last updated
- Jan 18, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | 240000780 | CA | Yes |
Other names
- Northeast Dialysis (Doing Business As)
Practice location
3501 Mall View RdSte 109
Bakersfield, CA 93306-3045
Phone 661-872-3580 · Fax 661-872-3554
Mailing address
5200 Virginia WayL & C Dept
Brentwood, TN 37027-7569
Phone 615-238-3085 · Fax 800-268-9682
Authorized official
Samuel T. Wey
Vp, Licensure & Certification
6153416641
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