Organization
SRS-WATSONVILLE, LLC
Active
Other names
Sanderling DIalysis of Watsonville
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME TANNENNBAUM (CEO)
(615) 988-7881
Entity
Organization
Contact information
Practice address
65 NEILSON ST STE 145, WATSONVILLE, CA 95076-2491
(615) 499-5122
(855) 631-0206
Mailing address
PO BOX 198813, NASHVILLE, TN 37219-8813
(615) 988-7881
(855) 631-0206
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
10/01/2019
Last updated
02/16/2021
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