Organization
IRC-SUTTER HEALTH JACKSON LLC
Active
Other names
INNOVATIVE RENAL CARE JACKSON DIALYSIS CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SARA ANNE BRADY (AUTHORIZED OFFICIAL)
(208) 371-7878
Entity
Organization
Contact information
Practice address
12030 INDUSTRY BLVD, JACKSON, CA 95642-9371
(209) 273-3060
(209) 273-3374
Mailing address
12030 INDUSTRY BLVD, JACKSON, CA 95642-9371
(209) 273-3060
(209) 273-3374
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
11/15/2023
Last updated
01/23/2024
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