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
2300 E 3RD ST, CHATTANOOGA, TN 37404-2734
(423) 698-6422
(423) 622-8223
Mailing address
2300 E 3RD ST, CHATTANOOGA, TN 37404-2734
(423) 698-6422
(423) 622-8223
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0000000079
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000738328A
—
GA
05
—
0442596
—
TN
05
—
TN0110
—
IL
Enumeration date
07/08/2006
Last updated
10/04/2023
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