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
998 E MAIN ST, SUITE 206, DANVILLE, IN 46122-1971
(317) 745-8781
(317) 745-8785
Mailing address
1719 W 10TH ST, INDIANAPOLIS, IN 46222-3801
(317) 631-2005
(317) 631-0597
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200144940A
—
IN
Enumeration date
07/19/2006
Last updated
10/04/2023
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