Organization
DIALYSIS CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONOVAN SCHULTZ (PRESIDENT)
(615) 327-3061
Entity
Organization
Contact information
Practice address
1203 N. MISSOURI ST, MACON, MO 63552
(660) 385-1001
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
08/18/2014
Last updated
10/05/2023
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