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
901 W MAIN ST, FREEHOLD, NJ 07728-2537
(732) 940-4460
(732) 294-5755
Mailing address
901 W MAIN ST, FREEHOLD, NJ 07728-2537
(732) 294-5700
(732) 294-5755
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
22462
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7893701
—
NJ
Enumeration date
07/08/2006
Last updated
10/05/2023
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