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DVA HEALTHCARE RENAL CARE INC NPI 1477512515


NPI Information

NPI: 1477512515
Provider Name: DVA HEALTHCARE RENAL CARE INC

Doing Business As: CHATEAU DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 19D0457738

Address:
720 VILLAGE RD
KENNER, LA
ZIP 70065
Phone: (504) 469-2796
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DVA HEALTHCARE RENAL CARE INC is an end-stage renal disease (esrd) treatment clinic center in Kenner, LA. DVA HEALTHCARE RENAL CARE INC NPI is 1477512515. The provider is registered as an organization entity type.
The provider Is Doing Business As Chateau Dialysis.

The provider's business location address is:

720 VILLAGE RD
KENNER, LA
ZIP 70065-751
Phone: (504) 469-2796
Fax: (504) 469-7587

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 19D0457738 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/18/2006 and was last updated on 10/18/2022.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment115LOUISIANAYes

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
11350281MEDICAIDLOUISIANA

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: 5/5/2024

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