DVA HEALTHCARE OF MASSACHUSETTS INC NPI 1760441745

NPI Information

  • NPI: 1760441745
  • Provider Name: DVA HEALTHCARE OF MASSACHUSETTS, INC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: PLYMOUTH DIALYSIS
  • Address: 45 RESNICK RD
    PLYMOUTH, MA
    ZIP 02360
  • Phone: (508) 747-5444

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NPI Details

DVA HEALTHCARE OF MASSACHUSETTS, INC is an end-stage renal disease (esrd) treatment clinic center in Plymouth, MA. DVA HEALTHCARE OF MASSACHUSETTS, INC NPI is 1760441745. The provider is registered as an organization entity type.
The provider Is Doing Business As Plymouth Dialysis.

The provider's business location address is:

45 RESNICK RD
PLYMOUTH, MA
ZIP 02360-844
Phone: (508) 747-5444
Fax: (508) 747-5331

The provider's authorized official is Thomas O Usiltion .
The authorized official title is Graoup Vice President and has the following contact phone number (770) 541-7922.

The enumeration date for this NPI number is 3/20/2006 and was last updated on 8/22/2020.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentEA1AMASSACHUSETTSYes

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
11311352MEDICAIDMASSACHUSETTS

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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