Organization
SRS-CRESCENT CITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME TANNENBAUM MD, PHD, FACP (CEO)
(615) 467-0140
Entity
Organization
Contact information
Practice address
780 E WASHINGTON BLVD, BUILDING B, CRESCENT CITY, CA 95531-8397
(615) 467-0140
Mailing address
PO BOX 198813, NASHVILLE, TN 37219-8397
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
03/21/2017
Last updated
11/23/2020
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