Organization
DIALYSIS CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONOVAN SCHULTZ (PRESIDENT)
(615) 329-2513
Entity
Organization
Contact information
Practice address
950 HAMILTON ST, SOMERSET, NJ 08873-3338
(732) 214-9128
(732) 214-9158
Mailing address
117 N CENTER DR, NORTH BRUNSWICK, NJ 08902-4910
(732) 565-5440
(732) 565-5441
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
22638
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8449503
—
NJ
Enumeration date
07/08/2006
Last updated
10/04/2023
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