MEDICARE: DVA RENAL HEALTHCARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	0274	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306812771
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DVA RENAL HEALTHCARE INC

Provider Business Mailing Address
First Line	:	5200 VIRGINIA WAY
Second Line	:	L & C DEPT
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7569
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	780 LITCHFIELD ST
Second Line	:	STE 100
City	:	TORRINGTON
State	:	CT
Zip	:	06790-6268
Country	:	US
Telephone Number	:	860-496-0661
Fax Number	:	860-496-0504

Authorized Official
Title or Position	:	VP LICENSURE & CERTIFICATION
Name	:	SAMUEL T WEY
Credential	:
Telephone Number	:	615-341-6641

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	01/07/2025

Similar Medicare Providers

1255267001 — KATELYN MARY RICHARD
Practice Location Address:

780 LITCHFIELD ST
TORRINGTON, CT
06790-6268

Practice Phone: 860-482-8578
Practice Fax:

1760464903 — JEAN K EVANGELISTI APRN
Practice Location Address:

780 LITCHFIELD ST , SUITE 200
TORRINGTON, CT
06790-6268

Practice Phone: 860-489-1984
Practice Fax: 860-496-2195

1124003892 — MICHAEL T KOVALCHIK M.D.
Practice Location Address:

780 LITCHFIELD ST , SUITE200
TORRINGTON, CT
06790-6268

Practice Phone: 860-489-1984
Practice Fax: 860-496-2195

1407944689 — DIABETES AND ENDOCRINOLOGY OF NORTHWESTERN CONNECTICUT
Practice Location Address:

780 LITCHFIELD ST
TORRINGTON, CT
06790-6268

Practice Phone: 860-496-2198
Practice Fax: 860-489-2482

1619065976 — DR. EGILS KNUTS BOGDANOVICS M.D.
Practice Location Address:

780 LITCHFIELD ST
TORRINGTON, CT
06790-6268

Practice Phone: 860-496-2198
Practice Fax: 860-489-2482

1962560458 — NEPHROLOGY ASSOCIATES OF NORTHWESTERN CONNECTICUT LLP
Practice Location Address:

780 LITCHFIELD ST , SUITE 200
TORRINGTON, CT
06790-6268

Practice Phone: 860-489-1984
Practice Fax: 860-496-2195

Directions to “DVA RENAL HEALTHCARE INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.