DVA RENAL HEALTHCARE INC (NPI# 1023081999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023081999 |
| Entity Type | Organization |
| Organization Name | DVA RENAL HEALTHCARE INC |
| Other Organization Name | NOGALES DIALYSIS |
| Practice Address |
1605 N Industrial Park Dr Ste H Nogales AZ 85621-4577 |
| Mailing Address |
5200 Virginia Way L & C Dept Brentwood TN 37027-7569 |
| Practice Telephone | 5202815779 |
| Practice Fax Number | 5202815873 |
| Mailing Telephone | 6153416814 |
| Mailing Fax Number | 8002938405 |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2020-04-14 |
| Authorized Official Name | JOHN WINSTEL (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334501 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
OTC0597 | AZ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 130047 | 05 |
| Other Name | Type Code |
|---|---|
| Nogales Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629415609 | Dva Renal Healthcare Inc | Clinic/Center | 300 B 22nd St South, Birmingham, AL 35233-2209 | 2013-05-30 |
| 1164728408 | Dva Renal Healthcare Inc | Clinic/Center | 415 W Nc Hwy 54, Durham, NC 27713-7516 | 2011-02-03 |
| 1295983245 | Dva Renal Healthcare Inc | Clinic/Center | 1919 Charlotte Ave Ste 200, Nashville, TN 37203-2245 | 2008-09-03 |
| 1811171440 | Dva Renal Healthcare Inc | Clinic/Center | 300 W Broadway Ste 150, Council Bluffs, IA 51503-9077 | 2007-12-18 |
| 1881623585 | Dva Renal Healthcare Inc | Clinic/Center | 271 King St, Perth Amboy, NJ 08861-4488 | 2006-07-03 |
| 1164451852 | Dva Renal Healthcare Inc | Clinic/Center | 262 Texas Rd, Ste 101, Old Bridge, NJ 08857-4008 | 2006-07-03 |
| 1912936618 | Dva Renal Healthcare Inc | Clinic/Center | 1200 Randolph Rd, Muhlenburg Campus, Plainfield, NJ 07060-3361 | 2006-07-03 |
| 1346270782 | Dva Renal Healthcare Inc | Clinic/Center | 230 Van Sciver Pkwy, Willingboro, NJ 08046-1131 | 2006-07-03 |
| 1548299381 | Dva Renal Healthcare Inc | Clinic/Center | 29 Meridian Rd, Edison, NJ 08820-2823 | 2006-07-02 |
| 1548299373 | Dva Renal Healthcare Inc | Clinic/Center | 14-20 Prospect St, East Orange, NJ 07017-2238 | 2006-07-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | DVA Renal Healthcare Inc. | 2000 16th St, Jld/secgovfin, Denver, Colorado 80202-5117 |
| Street Address |
1605 N INDUSTRIAL PARK DR STE H |
| City | NOGALES |
| State | AZ |
| Zip Code | 85621-4577 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548771033 | Intermountain Health Center, Inc. | Community/Behavioral Health | 272 West Viewpoint Drive, Nogales, AZ 85621 | 2017-10-24 |
| 1336696657 | Intermountain Centers for Human Development Inc. | Community/Behavioral Health | 276 West View Point Drive, Nogales, AZ 85621 | 2016-09-02 |
| 1831584291 | Helping Ourselves Pursue Enrichment, Inc. | Community/Behavioral Health | 1857 N Mastick Way, Nogales, AZ 85621 | 2015-04-02 |
| 1043504376 | Community Intervention Associates | Community/Behavioral Health | 32 Blvd Del Rey David, Nogales, AZ 85621 | 2011-06-03 |
| 1568782175 | Arizona's Children Association | Clinic/Center | 1740 N. Mastick Way, Suite D, Nogales, AZ 85621 | 2010-06-04 |
| 1811032493 | Susan M. Jaworski | Local Education Agency (LEA) | 315 Plum Street, Nogales, AZ 85621 | 2007-02-21 |
| 1194885905 | Alex Gracia | Pharmacy Technician | 839 W. Calle Chico, Nogales, AZ 85621 | 2006-12-11 |
| 1982716130 | Yvette Denise Braun | Chiropractor | 1821 N Mastick Way #1, Nogales, AZ 85621 | 2006-08-31 |
| 1043254154 | John Diaz | Emergency Medicine | 1171 W Target Range Road, Carondelet Holy Cross Hospital, Nogales, AZ 85621 | 2006-06-16 |
| 1467495085 | Bart L Mc Rae | Emergency Medicine | Carondelet Holy Cross Hospital, 1171 W. Target Range Road, Nogales, AZ 85621 | 2006-06-13 |
| Find all providers in zip 85621 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
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| 1437613916 | Premier Home Dialysis Services | Clinic/Center | 20118 N 67th Ave Ste 300-527, Glendale, AZ 85308-4621 | 2019-01-29 |
| 1801369186 | Bio Medical Applications of Arizona LLC | Clinic/Center | 7862 E Florentine Rd Ste 100, Prescott Valley, AZ 86314-2216 | 2019-01-09 |
| 1932688256 | Southwest Kidney Davita Dialysis Partners LLC | Clinic/Center | 926 E Mcdowell Rd Ste 100, Phoenix, AZ 85006-2503 | 2018-08-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.