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DVA HEALTHCARE RENAL CARE INC NPI 1992767149


NPI Information

NPI: 1992767149
Provider Name: DVA HEALTHCARE RENAL CARE INC

Doing Business As: SALEM DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
3550 LIBERTY RD S
STE 100
SALEM, OR
ZIP 97302
Phone: (503) 371-8047
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DVA HEALTHCARE RENAL CARE INC is an end-stage renal disease (esrd) treatment clinic center in Salem, OR. DVA HEALTHCARE RENAL CARE INC NPI is 1992767149. The provider is registered as an organization entity type.
The provider Is Doing Business As Salem Dialysis.

The provider's business location address is:

3550 LIBERTY RD S
STE 100
SALEM, OR
ZIP 97302-700
Phone: (503) 371-8047
Fax: (503) 371-7455

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

The enumeration date for this NPI number is 4/4/2006 and was last updated on 2/24/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment170047OREGONYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1195875MEDICAIDOREGON

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: 11/14/2023

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