Organization
DIALYSIS CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONOVAN SCHULTZ (PRESIDENT)
(615) 327-3061
Entity
Organization
Contact information
Practice address
644 ANTONE ST NW STE 8, ATLANTA, GA 30318-7666
(404) 230-2873
(404) 564-2100
Mailing address
644 ANTONE ST NW STE 8, ATLANTA, GA 30318-7666
(404) 230-2959
(404) 230-2966
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD00170
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00410616A
—
GA
Enumeration date
07/13/2006
Last updated
10/04/2023
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