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NPI Code Detail

MEDICARE: DIALYSIS CLINIC INC

MEDICARE: DIALYSIS CLINIC INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number : 1891140273
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIALYSIS CLINIC INC
Provider Business Mailing Address
First Line : 499 E MCMILLAN ST
Second Line : SUITE 900
City : CINCINNATI
State : OH
Zip : 45206-1924
Country : US
Telephone Number : 513-281-0091
Fax Number : 513-221-3425
Provider Business Practice Location Address
First Line : 4600 BEECHWOOD RD
Second Line : SUITE 900
City : CINCINNATI
State : OH
Zip : 45244-1809
Country : US
Telephone Number : 513-528-3222
Fax Number : 513-528-0434
Authorized Official
Title or Position : PRESIDENT
Name : MR. DONOVAN SCHULTZ
Credential :
Telephone Number : 615-327-3061
Provider Enumeration Date : 05/04/2016
Last Update Date : 10/05/2023

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