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NPI Code Detail

MEDICARE: DVA RENAL HEALTHCARE INC

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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number : 1043441710
Entity Type Code : Organization
Provider Name (Legal Business Name) : DVA RENAL HEALTHCARE INC
Provider Business Mailing Address
First Line : 5200 VIRGINIA WAY
Second Line : STE 400 L&C DEPT
City : BRENTWOOD
State : TN
Zip : 37027-7569
Country : US
Telephone Number : 615-320-4521
Fax Number : 866-594-2894
Provider Business Practice Location Address
First Line : 3545 NW 58TH ST
Second Line : STE 600
City : OKLAHOMA CITY
State : OK
Zip : 73112-4726
Country : US
Telephone Number : 405-527-8996
Fax Number : 405-527-8989
Authorized Official
Title or Position : VICE PRESIDENT
Name : JAMES K HILGER
Credential :
Telephone Number : 253-382-1919
Provider Enumeration Date : 07/29/2009
Last Update Date : 07/29/2009

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Directions to “DVA RENAL HEALTHCARE INC ” Practice Location

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