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
608 W DUE WEST AVE, MADISON, TN 37115-4402
(615) 865-7310
(615) 860-2061
Mailing address
608 W DUE WEST AVE, MADISON, TN 37115
(615) 865-7310
(615) 860-2061
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0000000029
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0442507
—
TN
05
—
39962022
—
KY
Enumeration date
06/30/2006
Last updated
10/05/2023
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