DIALYSIS CLINIC INC. NPI 1306874953

NPI Information

NPI: 1306874953
Provider Name: DIALYSIS CLINIC, INC.
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 44D0315531

Address:
93 RIDGECREST RD
JACKSON, TN
ZIP 38305
Phone: (731) 668-0800
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DIALYSIS CLINIC, INC. is an end-stage renal disease (esrd) treatment clinic center in Jackson, TN. DIALYSIS CLINIC, INC. NPI is 1306874953. The provider is registered as an organization entity type.

The provider's business location address is:

93 RIDGECREST RD
JACKSON, TN
ZIP 38305-361
Phone: (731) 668-0800
Fax: (731) 668-1994

The provider's authorized official is Donovan Schultz .
The authorized official title is President and has the following contact phone number (615) 327-3061.

The CLIA number assigned to this NPI record is 44D0315531 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/30/2006 and was last updated on 10/4/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	0000000062	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	044 2504	MEDICAID	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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