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
1700 W COMMERCE POINT PL, GREEN VALLEY, AZ 85614-5095
(520) 327-0007
(520) 327-6902
Mailing address
2022 E PRINCE RD, TUCSON, AZ 85719-2005
(520) 327-0007
(520) 327-6902
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
341615
—
AZ
Enumeration date
06/04/2007
Last updated
10/05/2023
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