DVA RENAL HEALTHCARE INC NPI 1619940764

NPI Information

NPI: 1619940764
Provider Name: DVA RENAL HEALTHCARE INC

Doing Business As: SYLACAUGA DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
331 JAMES PAYTON BLVD
SYLACAUGA, AL
ZIP 35150
Phone: (256) 249-4994
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DVA RENAL HEALTHCARE INC is an end-stage renal disease (esrd) treatment clinic center in Sylacauga, AL. DVA RENAL HEALTHCARE INC NPI is 1619940764. The provider is registered as an organization entity type.
The provider Is Doing Business As Sylacauga Dialysis.

The provider's business location address is:

331 JAMES PAYTON BLVD
SYLACAUGA, AL
ZIP 35150-064
Phone: (256) 249-4994
Fax: (256) 249-2786

The provider's authorized official is John Winstel .
The authorized official title is Chief Accounting Officer, Treasurer and has the following contact phone number (253) 733-4501.

The CLIA number assigned to this NPI record is 01D0950542 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/9/2006 and was last updated on 6/23/2023.

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	S6101	ALABAMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DIA2588D	MEDICAID	ALABAMA

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

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