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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
1213 BONITA ST, GRANTS, NM 87020-2103
(505) 285-5200
(505) 285-5540
Mailing address
1213 BONITA ST, GRANTS, NM 87020-2103
(505) 285-5200
(505) 285-5540

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
6377A1
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01436
ND
05
N5003
NM
Enumeration date
07/08/2006
Last updated
10/04/2023
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