Organization
SRS-ELY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME SEYMOUR TANNENBAUM M.D.,PHS, FACP (PRESIDENT)
(615) 467-0140
Entity
Organization
Contact information
Practice address
701 EAST 15TH STREET, ELY, NV 89301
(615) 467-0140
(615) 259-0693
Mailing address
PO BOX 198813, NASHVILLE, TN 37219-8813
(615) 467-0140
(615) 259-0693
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
11/19/2013
Last updated
11/23/2020
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