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
21 NELSON ST, AUBURN, NY 13021-2601
(315) 255-9004
(315) 255-0761
Mailing address
21 NELSON ST, AUBURN, NY 13021-2601
(315) 255-9004
(315) 255-0761
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
3301213R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03007852
—
NY
Enumeration date
07/24/2006
Last updated
10/04/2023
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