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
2270 TECHNICAL PKWY, CHARLESTON, SC 29406-4930
(843) 723-7227
(843) 863-9590
Mailing address
2270 TECHNICAL PKWY, CHARLESTON, SC 29406-4930
(843) 863-8974
(843) 863-9590
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ERD-006
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
422524
—
SC
Enumeration date
07/08/2006
Last updated
10/04/2023
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