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
900 S 6TH ST, RATON, NM 87740-4224
(575) 445-4300
(575) 445-4141
Mailing address
900 S 6TH ST, RATON, NM 87740-4224
(575) 445-4300
(575) 445-4141
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
3166
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04354524
—
NM
05
—
45997
—
CA
Enumeration date
07/08/2006
Last updated
10/04/2023
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