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
120 PIEDMONT AVE NE, ATLANTA, GA 30303-2418
(404) 230-2959
Mailing address
120 PIEDMONT AVE NE, ATLANTA, GA 30303-2418
(404) 230-2967
(404) 230-2976
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD001041
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000074346A
—
GA
05
—
000410616A
—
GA
Enumeration date
06/30/2006
Last updated
10/04/2023
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