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
325 W 6TH ST, EAST LIVERPOOL, OH 43920-2803
(330) 382-0835
(330) 382-0840
Mailing address
325 W 6TH ST, EAST LIVERPOOL, OH 43920-2803
(330) 382-0835
(330) 382-0840
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0562DC
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005814000
—
WV
05
—
01704094
—
PA
05
—
0744127
—
OH
Enumeration date
07/08/2006
Last updated
10/04/2023
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