Organization
SRS-UTAH LLC
Active
Organization
SRS-UTAH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEROME S TANNENBAUM MD (CEO/PRESIDENT)
(855) 754-7365
Entity
Organization
Contact information
Practice address
511 UNION ST STE 1800, NASHVILLE, TN 37219-2509
(615) 499-5199
(615) 259-0693
Mailing address
511 UNION ST STE 1800, NASHVILLE, TN 37219-2509
(615) 499-5199
(615) 259-0693
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
10/28/2021
Last updated
10/28/2021
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