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
132 FUTURE DR, CORBIN, KY 40701-8989
(606) 528-6006
(606) 528-6033
Mailing address
100 VENTURE CT, LEXINGTON, KY 40511-2600
(859) 252-7712
(859) 252-2117
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
300037
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1516447
—
TN
05
—
39090071
—
KY
Enumeration date
07/08/2006
Last updated
10/05/2023
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