Organization
SHANNON JOINT VENTURES, INC
Active
Parent organization
SHANNON HEALTH SYSTEMS
Other names
SHANNON DIALYSIS CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHANNON HEALTH SYSTEMS
Authorized official
JOHN GILBREATH (CHIEF FINANCIAL OFFICER)
(325) 658-1511
Entity
Organization
Contact information
Practice address
2018 PULLIAM ST, SAN ANGELO, TX 76905-5148
(325) 659-7360
Mailing address
PO BOX 22000, SAN ANGELO, TX 76902-7200
(325) 659-7360
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
F1646
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148371102
—
TX
Enumeration date
11/17/2005
Last updated
12/18/2009
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