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DVA RENAL HEALTHCARE INC NPI 1629415609


NPI Information

NPI: 1629415609
Provider Name: DVA RENAL HEALTHCARE INC

Doing Business As: RED MOUNTAIN HOME TRAINING DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 01D2065082

Address:
300 B 22ND ST SOUTH
BIRMINGHAM, AL
ZIP 35233
Phone: (205) 250-6757
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DVA RENAL HEALTHCARE INC is an end-stage renal disease (esrd) treatment clinic center in Birmingham, AL. DVA RENAL HEALTHCARE INC NPI is 1629415609. The provider is registered as an organization entity type.
The provider Is Doing Business As Red Mountain Home Training Dialysis.

The provider's business location address is:

300 B 22ND ST SOUTH
BIRMINGHAM, AL
ZIP 35233-209
Phone: (205) 250-6757
Fax: (205) 458-0146

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 01D2065082 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/30/2013 and was last updated on 5/27/2021.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentS3734ALABAMAYes

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
1156375MEDICAIDALABAMA

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

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.