DVA HEALTHCARE OF MASSACHUSETTS INC NPI 1851350714

NPI Information

DVA HEALTHCARE OF MASSACHUSETTS INC is an end-stage renal disease (esrd) treatment clinic center in Wellesley, MA. DVA HEALTHCARE OF MASSACHUSETTS INC NPI is 1851350714. The provider is registered as an organization entity type.
The provider Is Doing Business As Wellesley Dialysis.

The provider's business location address is:

195 WORCESTER ST
LOWER LEVEL
WELLESLEY, MA
ZIP 02481-568
Phone: (781) 431-1414
Fax: (781) 431-1144

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

The CLIA number assigned to this NPI record is 22D2285674 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/20/2006 and was last updated on 8/14/2007.

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

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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