DVA RENAL HEALTHCARE INC NPI 1023071545

NPI Information

  • NPI: 1023071545
  • Provider Name: DVA RENAL HEALTHCARE INC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: MEMPHIS SOUTH DIALYSIS
  • Address: 1205 MARLIN RD
    MEMPHIS, TN
    ZIP 38116
  • Phone: (901) 346-6637

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NPI Details

DVA RENAL HEALTHCARE INC is an end-stage renal disease (esrd) treatment clinic center in Memphis, TN. DVA RENAL HEALTHCARE INC NPI is 1023071545. The provider is registered as an organization entity type.
The provider Is Doing Business As Memphis South Dialysis.

The provider's business location address is:

1205 MARLIN RD
MEMPHIS, TN
ZIP 38116-812
Phone: (901) 346-6637
Fax: (901) 346-7884

The provider's authorized official is Samuel T Wey .
The authorized official title is Sr Director Licensure&certification and has the following contact phone number (615) 341-6641.

The enumeration date for this NPI number is 4/7/2006 and was last updated on 10/5/2023.

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
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment136TENNESSEEYes

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
1202575213MEDICAIDMISSOURI
2202575213MEDICAIDMARYLAND
3152749734MEDICAIDARKANSAS
405820307MEDICAIDMISSISSIPPI
5500431309MEDICAIDMISSOURI
60442649MEDICAIDTENNESSEE

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: 3/30/2025

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