Dva Healthcare Renal Care INC
Clinic/Center, End-Stage Renal Disease (ESRD) Treatment in Demopolis, AL. Organization (NPI-2).
NPI number1477526754
StatusActive
Last updated in NPPESMay 23, 2025
Details
- NPI
- 1477526754
- Entity type
- Organization (NPI-2)
- Legal business name
- Dva Healthcare Renal Care INC
- Organization subpart
- No
- Enumeration date
- Feb 8, 2006
- Certification date
- May 23, 2025
- Last updated
- May 23, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | S4601 | AL | Yes |
Other names
- Demopolis Dialysis (Doing Business As)
Practice location
305 S Cedar AveDemopolis, AL 36732-2231
Phone 334-289-1394 · Fax 334-289-1015
Mailing address
5200 Virginia WayL&C Dept
Brentwood, TN 37027-7569
Authorized official
Samuel T Wey
Vp Licensure & Certification
6153416641
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