Dva Healthcare Renal Care Inc

Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Barnwell, SC

NPI 1669434775 · NPPES record last updated Jul 10, 2007

Key facts

NPI
1669434775
Entity type
Organization (NPI type 2)
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
License
ERD029 (SC)
Legal business name
DVA HEALTHCARE RENAL CARE INC
Practice address
914 Reynolds Rd
Barnwell, SC 29812-6358
Phone
(803) 259-5805
Fax
(803) 259-5176
NPI assigned
Apr 4, 2006
Organization subpart
No

Authorized official

Name
Thomas O Usilton Jr.
Title
Group Vice President
Phone
(770) 541-7922

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X ERD029 SC Yes

Addresses

Primary practice location

914 Reynolds Rd
Barnwell, SC 29812-6358

Mailing address

5200 Virginia Way
Ste. 400 L&C
Brentwood, TN 37027-7569
Phone (615) 320-4218

Other identifiers

IdentifierTypeStateIssuer
425258MedicaidSC

Other names

  • Barnwell Dialysis Doing business as

Other providers in Barnwell, SC

All providers in Barnwell, SC · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in South Carolina

Sources for this page

Verify at the official NPI Registry.