Provider Demographics
NPI:1851310098
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 1:3260 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3026
Mailing Address - Country:US
Mailing Address - Phone:412-647-3700
Mailing Address - Fax:412-647-6980
Practice Address - Street 1:6314 FORBES AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1717
Practice Address - Country:US
Practice Address - Phone:412-521-4370
Practice Address - Fax:412-521-4371
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
PA1022869480008Medicaid
PA2041981Medicaid
PA1022869480008Medicaid