462504 Srs-Provo, LLC
462504 Srs-Provo, LLC is the legal business name for a medical facility located in Provo, Utah. The entity is registered under the National Provider Identifier (NPI) number 1679147904, with the enumeration date of May 20, 2021. The authorized official for the LLC is listed as Jerome Tannenbaum, who holds the title of CEO and Chairman of the Board. The facility operates as an End-Stage Renal Diseas
Provo, UT
Photos
Care types: Dialysis, Memory Care
Trust signals
- License: 462504
- Accepts Medicare
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- Utah County Health Department
- Utah Valley Specialty Hospital
- Beehive Homes Of Provo #2
- Utah Valley Regional Medical Center
- Utah Valley Regional Medical Center