Organization Name: | DVA RENAL HEALTHCARE INC |
NPI Number: | 1043277015 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES K HILGER (GROUP VICE PRESIDENT) |
Mailing Address: | 3363 Nw 167th St Miami Gardens |
State: | FL US |
Postal Code: | 330564254 |
Phone Number: | 3056279311 |
Fax Number: | 3056289389 |
NPI Enumeration Date: | 04/26/2006 |
NPI Last Update Date: | 01/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |