Dva Healthcare Southwest Ohio LLC

NPI #1720042096 in Fairfield, Ohio

Provider Information

NPI Number: 1720042096
Entity Type: Organization
Organization Name: Dva Healthcare Southwest Ohio LLC
Primary Specialty: Clinic/Center - End-Stage Renal Disease (ESRD) Treatment
Enumeration Date: Apr 13, 2006
Last Updated: Nov 7, 2023

Practice Location

Address: 1210 HICKS BLVD
City: Fairfield
State: Ohio
ZIP Code: 45014-1921
Phone: (513) 939-1110

Authorized Official

Name: SAMUEL T WEY
Title: VP, LICENSURE & CERTIFICATION
Phone: (615) 341-6641

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment — End-Stage Renal Disease (ESRD) Treatment	261QE0700X	Primary

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