DVA HEALTHCARE RENAL CARE INC NPI 1730141896

NPI Information

DVA HEALTHCARE RENAL CARE INC is an end-stage renal disease (esrd) treatment clinic center in Philadelphia, PA. DVA HEALTHCARE RENAL CARE INC NPI is 1730141896. The provider is registered as an organization entity type.
The provider Is Doing Business As Cobbs Creek Dialysis.

The provider's business location address is:

1700 S 60TH ST
PHILADELPHIA, PA
ZIP 19142-404
Phone: (215) 730-0500
Fax: (215) 730-0600

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 CLIA number assigned to this NPI record is 39D0940329 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/4/2006 and was last updated on 11/17/2020.

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:

Other Identifiers

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