Organization
DIALYSIS CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONOVAN SCHULTZ (PRESIDENT)
(615) 327-3061
Entity
Organization
Contact information
Practice address
337 5TH AVE, ALBANY, GA 31701-2029
(229) 888-3996
(229) 888-6668
Mailing address
337 FIFTH AVE, ALBANY, GA 31701-2029
(229) 888-3996
(229) 888-6668
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD001011
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000407393A
—
GA
05
—
00138498A
—
GA
Enumeration date
06/30/2006
Last updated
04/25/2023
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