DVA RENAL HEALTHCARE INC NPI 1154381697

NPI Information

DVA RENAL HEALTHCARE INC is an end-stage renal disease (esrd) treatment clinic center in Alton, IL. DVA RENAL HEALTHCARE INC NPI is 1154381697. The provider is registered as an organization entity type.
The provider Is Doing Business As Alton Dialysis.

The provider's business location address is:

309 HOMER ADAMS PKWY
ALTON, IL
ZIP 62002-929
Phone: (618) 462-0186
Fax: (618) 462-0213

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

The CLIA number assigned to this NPI record is 14D0989404 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/27/2006 and was last updated on 4/22/2021.

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:

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.