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
544 S MCDONOUGH ST, MONTGOMERY, AL 36104-4614
(334) 265-9190
(334) 241-4339
Mailing address
544 S MCDONOUGH ST, MONTGOMERY, AL 36104-4614
(334) 265-9190
(334) 241-4339
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
07979
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02388758
—
MS
05
—
62-2850498
—
OH
05
—
DIA2576D
—
AL
Enumeration date
07/08/2006
Last updated
10/04/2023
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