Dialysis Clinic Inc.

LBN: Dialysis Clinic Inc.
Dialysis Clinic Inc. is an health care organization with primary practice located at 155 Brandywine Blvd , Fayetteville GA 30214-7628. The organization recently has only one registered license in Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, which is considered as the primary health care specialty. Dialysis Clinic Inc. can be contacted via phone (770) 716-6940, or through Schultz, Donovan via phone (615) 327-3061.

Contact Information

Primary practice address
155 Brandywine Blvd Fayetteville GA 30214-7628
Phone: (770) 716-6940
Fax: (770) 716-6944
Website:
Map and Directions
Authorized official contact:
Name: Schultz, Donovan
Phone: (615) 327-3061

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X ESRD001036 Georgia

Profile Details

NPI number 1043243421
LBN Legal business name Dialysis Clinic Inc.
DBA Doing business as
Authorized official Schultz, Donovan
Entity Organization
Organization subpart 1 No
Enumeration date Jul 8th, 2006
Last updated Oct 4th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043243421 NPPES
Georgia MEDICAID 000774287B
Georgia MEDICAID 00774287A
Georgia MEDICAID 00774287A

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