DVA RENAL HEALTHCARE INC NPI 1336100734

NPI Information

NPI: 1336100734
Provider Name: DVA RENAL HEALTHCARE INC

Doing Business As: DECATUR EAST WOOD DIALYSIS

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
794 E WOOD ST
DECATUR, IL
ZIP 62523
Phone: (217) 425-6403
Get Directions

DVA RENAL HEALTHCARE INC is an end-stage renal disease (esrd) treatment clinic center in Decatur, IL. DVA RENAL HEALTHCARE INC NPI is 1336100734. The provider is registered as an organization entity type.
The provider Is Doing Business As Decatur East Wood Dialysis.

The provider's business location address is:

794 E WOOD ST
DECATUR, IL
ZIP 62523-155
Phone: (217) 425-6403
Fax: (217) 425-8724

The provider's authorized official is Samuel T Wey .
The authorized official title is Vp, Licensure & Certification and has the following contact phone number (615) 341-6641.

The CLIA number assigned to this NPI record is 14D0981145 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/28/2006 and was last updated on 2/13/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	N/A	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »