DVA HEALTHCARE RENAL CARE INC NPI 1942272414

NPI Information

NPI: 1942272414
Provider Name: DVA HEALTHCARE RENAL CARE INC

Doing Business As: ATHENS DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
15953 ATHENS LIMESTONE DR
ATHENS, AL
ZIP 35613
Phone: (256) 233-4730
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DVA HEALTHCARE RENAL CARE INC is an end-stage renal disease (esrd) treatment clinic center in Athens, AL. DVA HEALTHCARE RENAL CARE INC NPI is 1942272414. The provider is registered as an organization entity type.
The provider Is Doing Business As Athens Dialysis.

The provider's business location address is:

15953 ATHENS LIMESTONE DR
ATHENS, AL
ZIP 35613-214
Phone: (256) 233-4730
Fax: (256) 233-4755

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

The CLIA number assigned to this NPI record is 01D0682937 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/7/2006 and was last updated on 4/19/2022.

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	S4201	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	DIA2517D	MEDICAID	ALABAMA
2	0012517	MEDICAID	TENNESSEE

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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