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
155 DILLON DR, SPARTANBURG, SC 29307-1017
(864) 585-4840
(864) 585-2053
Mailing address
155 DILLON DR, SPARTANBURG, SC 29307-1017
(864) 585-4840
(864) 585-2053
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ERD-022
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4202522
—
NC
05
—
425221
—
SC
Enumeration date
07/08/2006
Last updated
10/04/2023
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