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
822 WILD AVE., EVERGREEN, AL 36401-2545
(251) 578-9200
(251) 578-9300
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
S1801
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129625
—
AL
Enumeration date
07/30/2010
Last updated
07/30/2024
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