Lakeland South Dialysis

LBN: Dva Renal Healthcare Inc
Lakeland South Dialysis is an health care organization with primary practice located at 4774 S Florida Ave , Lakeland FL 33813-2181. 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 Renal Healthcare Inc can be contacted via phone (863) 646-0462, or through Wey, Samuel T via phone (615) 341-6641.

Contact Information

Primary practice address
4774 S Florida Ave Lakeland FL 33813-2181
Phone: (863) 646-0462
Fax: (863) 647-0802
Website:
Map and Directions
Authorized official contact:
Name: Wey, Samuel T
Phone: (615) 341-6641

Health care specialties

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

Profile Details

NPI number 1376510487
LBN Legal business name Dva Renal Healthcare Inc
DBA Doing business as Lakeland South Dialysis
Authorized official Wey, Samuel T
Entity Organization
Organization subpart 1 No
Enumeration date Mar 7th, 2006
Last updated Nov 17th, 2023 - about last year

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 1376510487 NPPES
Florida MEDICAID 890032900

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