Wylds Road Dialysis

LBN: Dva Healthcare Renal Care Inc
Wylds Road Dialysis is an health care organization with primary practice located at 1815 Wylds Rd , Augusta GA 30909-4430. 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 (706) 733-0522, or through Winstel, John via phone (253) 733-4501.

Contact Information

Primary practice address
1815 Wylds Rd Augusta GA 30909-4430
Phone: (706) 733-0522
Fax: (706) 733-0432
Website:
Map and Directions
Authorized official contact:
Name: Winstel, John
Phone: (253) 733-4501

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X ESRD001090 Georgia

Profile Details

NPI number 1972572949
LBN Legal business name Dva Healthcare Renal Care Inc
DBA Doing business as Wylds Road Dialysis
Authorized official Winstel, John
Entity Organization
Organization subpart 1 No
Enumeration date Mar 14th, 2006
Last updated Oct 26th, 2021 - about 3 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 1972572949 NPPES
Georgia MEDICAID 000534388A
Georgia MEDICAID 125797

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