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
1010 BEHRMAN HWY, GRETNA, LA 70056-4566
(504) 391-9572
(504) 391-0248
Mailing address
1010 BEHRMAN HWY, GRETNA, LA 70056-4566
(504) 391-9572
(504) 391-0248
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
067
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09137000
—
MS
05
—
1995576
—
LA
Enumeration date
07/08/2006
Last updated
10/04/2023
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