Organization
DIALYSIS CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONOVAN SCHULTZ (PRESIDENT)
(615) 327-3061
Entity
Organization
Contact information
Practice address
2020 BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71118-3315
(318) 683-4475
(318) 683-4476
Mailing address
1322 KINGS HWY, SHREVEPORT, LA 71103-4225
(318) 226-1020
(318) 424-1179
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
10/04/2017
Last updated
10/04/2023
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