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
1425 E 3RD ST, CHATTANOOGA, TN 37404-2435
(423) 698-0922
(423) 629-5053
Mailing address
1425 E 3RD ST, CHATTANOOGA, TN 37404-2435
(423) 698-0922
(423) 629-5053
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0000000039
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000551856A
—
GA
05
—
0442505
—
TN
05
—
444-7970
—
PA
05
—
TN0110
—
IL
Enumeration date
06/30/2006
Last updated
10/05/2023
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