Organization
PURE LIFE RENAL OF COOL SPRINGS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF FERNANDEZ (CFO)
(954) 962-5734
Entity
Organization
Contact information
Practice address
1648 WESTGATE CIR STE 100, BRENTWOOD, TN 37027-8019
(954) 962-5734
Mailing address
4000 HOLLYWOOD BLVD STE 300N, HOLLYWOOD, FL 33021-1242
(216) 264-0284
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
10/15/2019
Last updated
12/30/2020
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