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
1210 POPE DR, MAYSVILLE, KY 41056-8734
(606) 759-7689
(606) 759-4001
Mailing address
1210 POPE DR, MAYSVILLE, KY 41056-8734
(606) 759-7689
(606) 759-4001
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
300120
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2046306
—
OH
05
—
39090451
—
KY
Enumeration date
07/08/2006
Last updated
10/05/2023
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