Organization
DIALYSIS CLINIC INC.
Active
Organization
DIALYSIS CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONOVAN SCHULTZ (PRESIDENT)
(615) 327-3061
Entity
Organization
Contact information
Practice address
3861 SALEM RD., ENTERPRISE, AL 36330-7335
(334) 347-8233
(334) 347-3814
Mailing address
1630 COLUMBIA HWY, DOTHAN, AL 36303-5434
(334) 793-3519
(334) 793-6932
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
07930
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DIA2527D
—
AL
Enumeration date
07/08/2006
Last updated
10/04/2023
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