Organization
DIALYSIS CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONOVAN SCHULTZ (PRESIDENT)
(615) 327-3061
Entity
Organization
Contact information
Practice address
3300 LEMONE BLVD., COLUMBIA, MO 65201
(573) 443-1531
(573) 449-7653
Mailing address
3300 LEMONE BLVD., COLUMBIA, MO 65201
(573) 443-1531
(573) 449-7653
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
—
501565105
—
MO
05
—
620580498010
—
IL
Enumeration date
07/13/2006
Last updated
10/04/2023
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