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General NPI Number Information
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NPI Number | 1104888932
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Entity Type | Organization
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Legal Business Name | DVA HEALTHCARE OF PENNSYLVANIA LLC
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 03/02/2020
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Provider Practice Location Address
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Address Line | 4312 PENN AVE
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City | PITTSBURGH
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State | PA
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Zip | 15224-1310
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Country | US
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Telephone | 412-681-8556
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Fax | 412-681-8537
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Provider Business Mailing Address
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Address Line | 5200 VIRGINIA WAY L & C DEPT
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City | BRENTWOOD
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State | TN
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Zip | 37027-7569
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Country | US
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Telephone | 615-341-6410
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Fax | 888-662-8259
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Authorized Official
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Title or Position | CHIEF ACCOUNTING OFFICER
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Name | JOHN D WINSTEL
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Credential |
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Telephone | 253-733-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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