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
2613 FAIRWAY DR, SUITE E, FULTON, MO 65251-3789
(573) 592-1964
(573) 592-1968
Mailing address
3300 LEMONE INDUSTRIAL BLVD, COLUMBIA, MO 65201-8246
(573) 443-1531
(573) 449-3458
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
05/04/2016
Last updated
10/05/2023
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