Fairview Heights Dialysis

LBN: Dva Healthcare Renal Care, Inc.
Fairview Heights Dialysis is an health care organization with primary practice located at 821 Lincoln Hwy , Fairview Heights IL 62208-2216. The organization recently has only one registered license in Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, which is considered as the primary health care specialty. Dva Healthcare Renal Care, Inc. can be contacted via phone (618) 632-9550, or through Usilton, Thomas O via phone (770) 541-7922.

Contact Information

Primary practice address
821 Lincoln Hwy Fairview Heights IL 62208-2216
Phone: (618) 632-9550
Fax: (618) 632-8903
Website:
Map and Directions
Authorized official contact:
Name: Usilton, Thomas O
Phone: (770) 541-7922

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X

Profile Details

NPI number 1013986389
LBN Legal business name Dva Healthcare Renal Care, Inc.
DBA Doing business as Fairview Heights Dialysis
Authorized official Usilton, Thomas O
Entity Organization
Organization subpart 1 No
Enumeration date Mar 17th, 2006
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013986389 NPPES
Ohio MEDICAID 2300521

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