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
3555 BROAD ST, CHATTANOOGA, TN 37409-1028
(423) 756-8808
(423) 756-4397
Mailing address
3555 BROAD ST, CHATTANOOGA, TN 37409-1028
(423) 756-8808
(423) 756-4397
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0000000047
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000452537A
—
GA
05
—
00482457A
—
GA
05
—
044-2555
—
TN
05
—
TN0112
—
IL
Enumeration date
07/08/2006
Last updated
10/05/2023
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