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
870 NORTHSIDE DRIVE, SUITE 300, ATLANTA, GA 30318
(404) 888-4520
(404) 888-4529
Mailing address
870 NORTHSIDE DRIVE, SUITE 400, ATLANTA, GA 30318
(404) 230-2959
(404) 230-2966
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
—
000235089A
—
GA
05
—
000410605A
—
GA
Enumeration date
06/29/2006
Last updated
10/05/2023
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