Provider Demographics
NPI:1033138276
Name:DCI RENAL SERVICES OF PITTSBURGH LLC
Entity Type:Organization
Organization Name:DCI RENAL SERVICES OF PITTSBURGH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONOVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-327-3061
Mailing Address - Street 1:2534 MONROEVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2329
Mailing Address - Country:US
Mailing Address - Phone:412-823-6041
Mailing Address - Fax:412-823-6493
Practice Address - Street 1:2534 MONROEVILLE BLVD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2329
Practice Address - Country:US
Practice Address - Phone:412-823-6041
Practice Address - Fax:412-823-6493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1022869480003Medicaid
PA1206547Medicaid
PA1206547Medicaid