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
110 ASBURY DR, LANDRUM, SC 29356-1401
(864) 457-2435
(864) 457-3829
Mailing address
110 ASBURY DR, LANDRUM, SC 29356-1401
(864) 457-2435
(864) 457-3829
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ERD-106
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4202577
—
NC
05
—
4225776
—
SC
Enumeration date
07/19/2006
Last updated
10/05/2023
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