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
2029 N MOUNT JULIET RD, MOUNT JULIET, TN 37122-3316
(615) 889-3444
(615) 889-5111
Mailing address
1617 WILLIAMS DR, SUITE 100, MURFREESBORO, TN 37129-3285
(615) 890-7741
(615) 848-0570
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0000000076
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0442594
—
TN
05
—
1102300
—
OK
Enumeration date
07/08/2006
Last updated
10/04/2023
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