Healthcare Provider Details

I. General information

NPI: 1578596961
Provider Name (Legal Business Name): DCI RENAL SERVICES OF PITTSBURGH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 E PITTSBURGH MCKEESPORT BLVD
NORTH VERSAILLES PA
15137-2267
US

IV. Provider business mailing address

2534 MONROEVILLE BLVD
MONROEVILLE PA
15146-2329
US

V. Phone/Fax

Practice location:
  • Phone: 412-675-0960
  • Fax: 412-675-0965
Mailing address:
  • Phone: 412-823-6041
  • Fax: 412-823-6493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DONOVAN SCHULTZ
Title or Position: (MEMBER) PRESIDENT
Credential:
Phone: 615-327-3061