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
100 KEYSTONE DR STE E, RICHMOND, KY 40475-8587
(859) 625-0939
(859) 625-1980
Mailing address
100 KEYSTONE DR STE E, RICHMOND, KY 40475-8587
(859) 625-0939
(859) 625-1980
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
300107
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39090402
—
KY
Enumeration date
07/08/2006
Last updated
10/05/2023
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