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
1011 E PENNSYLVANIA ST, TUCSON, AZ 85714-3310
(520) 806-0071
(520) 806-0986
Mailing address
1011 E PENNSYLVANIA ST, TUCSON, AZ 85714-3310
(520) 806-0071
(520) 806-0986
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
OTC-0920
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
061375
—
AZ
05
—
359176
—
AZ
Enumeration date
07/08/2006
Last updated
10/05/2023
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