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Organization

SRS-PAYSON, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEROME TANNENBAUM MD (CEO AND CHAIRMAN OF THE BOARD)
(615) 467-0140
Entity
Organization

Contact information

Practice address
15 S 1000 E, PAYSON, UT 84651-5590
(888) 883-6407
(855) 631-0206
Mailing address
PO BOX 198813, NASHVILLE, TN 37219-8813
(615) 988-1060
(855) 631-0206

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary

Other

Enumeration date
05/20/2021
Last updated
05/21/2021
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