Dialysis Clinic INC.
Clinic/Center, End-Stage Renal Disease (ESRD) Treatment in Santo Domingo Pueblo, NM. Organization (NPI-2).
NPI number1285962001
StatusActive
Last updated in NPPESOct 4, 2023
Details
- NPI
- 1285962001
- Entity type
- Organization (NPI-2)
- Legal business name
- Dialysis Clinic INC.
- Organization subpart
- No
- Enumeration date
- Dec 7, 2009
- Certification date
- Oct 4, 2023
- Last updated
- Oct 4, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | – | – | Yes |
Practice location
85 West Highway 22Santo Domingo Pueblo, NM 87052
Phone 505-465-2003 · Fax 505-465-2165
Mailing address
1500 Indian School Rd NeAlbuquerque, NM 87102-1646
Phone 505-724-1500 · Fax 505-724-1528
Authorized official
Donovan Schultz
President
6153273061
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