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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/CenterESRD001039GA

Other Identifiers

General Provider Information

NPI Number : 1992738371
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIALYSIS CLINIC, INC.
Provider Business Mailing Address
First Line : 337 5TH AVE
Second Line :
City : ALBANY
State : GA
Zip : 31701-2029
Country : US
Telephone Number : 229-888-3996
Fax Number : 229-888-6668
Provider Business Practice Location Address
First Line : 1314 RADIUM SPRINGS RD # 20
Second Line :
City : ALBANY
State : GA
Zip : 31705-3620
Country : US
Telephone Number : 229-434-1175
Fax Number : 229-434-1459
Authorized Official
Title or Position : PRESIDENT
Name : MR. DONOVAN SCHULTZ
Credential :
Telephone Number : 615-327-3061
Provider Enumeration Date : 07/08/2006
Last Update Date : 10/05/2023

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Directions to “DIALYSIS CLINIC, INC. ” Practice Location

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