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
631 N BROAD STREET EXT, GROVE CITY, PA 16127-4603
(724) 458-0877
(724) 458-4566
Mailing address
201 HIGHPOINTE BLVD, SEVEN FIELDS, PA 16046-7923
(724) 779-3930
(724) 779-3966
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
—
1007529840055
—
PA
05
—
1648600
—
PA
Enumeration date
07/08/2006
Last updated
10/04/2023
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