Organization
DIALYSIS CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONOVAN SCHULTZ II (PRESIDENT)
(615) 327-3061
Entity
Organization
Contact information
Practice address
737 BROOKSHIRE DR, HERMITAGE, PA 16148-4507
(724) 342-3040
(724) 342-3346
Mailing address
737 BROOKSHIRE DR, HERMITAGE, PA 16148-4507
(724) 342-3040
(724) 342-3346
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007529840017
—
PA
05
—
1747378
—
PA
05
—
2220582
—
OH
Enumeration date
07/08/2006
Last updated
10/04/2023
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