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
240 PONCE DE LEON AVE NE, ATLANTA, GA 30308-1938
(404) 888-4530
(404) 888-4539
Mailing address
870 NORTHSIDE DR NW STE 400, ATLANTA, GA 30318-8499
(404) 230-2959
(404) 230-2966
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD001029
GA
Other
Enumeration date
07/08/2006
Last updated
10/05/2023
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