Organization Name: | DVA RENAL HEALTHCARE INC |
NPI Number: | 1295708808 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES HILGER (CHIEF ACCOUNTING OFFICER) |
Mailing Address: | Hwy 86 Milepost 113 Sells |
State: | AZ US |
Postal Code: | 856343030 |
Phone Number: | 5203831701 |
Fax Number: | 5203833667 |
NPI Enumeration Date: | 02/13/2006 |
NPI Last Update Date: | 05/28/2014 |
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: |