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
109 CONECUH AVE W, UNION SPRINGS, AL 36089-1317
(334) 738-5715
(334) 738-5734
Mailing address
109 CONECUH AVE W, UNION SPRINGS, AL 36089-1317
(334) 738-5715
(334) 738-5734
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
07924
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00685517B
—
GA
05
—
DIA2554D
—
AL
05
—
DIA2554D
—
IN
Enumeration date
07/08/2006
Last updated
10/04/2023
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