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Organization
RENAISSANCE SURGERY CENTER, LLC
Active
Organization
RENAISSANCE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL SERMONS (OWNER)
(423) 857-2028
Entity
Organization
Contact information
Practice address
320 BRISTOL WEST BLVD STE 1A, BRISTOL, TN 37620-8773
(423) 844-1399
Mailing address
PO BOX 9, ATTN CREDENTIALING, KINGSPORT, TN 37662
(423) 857-2066
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
01/10/2019
Last updated
03/16/2022
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