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
270 FARMINGTON AVE STE 160, FARMINGTON, CT 06032
(860) 678-1459
(860) 678-0185
Mailing address
270 FARMINGTON AVE, FARMINGTON, CT 06032-1909
(860) 678-1459
(860) 678-0185
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0260
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004201420
—
CT
05
—
004201430
—
CT
Enumeration date
07/19/2006
Last updated
10/05/2023
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