Organization
JEFFERSON CITY RENAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DONOVAN SCHULTZ (PRESIDENT)
(615) 327-3061
Entity
Organization
Contact information
Practice address
144 SCOTT STATION RD, JEFFERSON CITY, MO 65109-4974
(573) 893-5220
(573) 659-7516
Mailing address
144 SCOTT STATION RD, JEFFERSON CITY, MO 65109-4974
(573) 893-5220
(573) 659-7516
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
11/08/2017
Last updated
08/11/2023
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