SRS-AMERICAN FORK LLC NPI 1720653942

NPI Information

NPI: 1720653942
Provider Name: SRS-AMERICAN FORK, LLC
Classification: Clinic/Center - 261QE0700X
Specialization: End-Stage Renal Disease (ESRD) Treatment
Entity Type: Organization
CLIA Number: 46D1059271
Address: 1159 E 200 N
AMERICAN FORK, UT
ZIP 84003
Phone: (888) 893-7783

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NPI Details

SRS-AMERICAN FORK, LLC is an end-stage renal disease (esrd) treatment clinic center in American Fork, UT. SRS-AMERICAN FORK, LLC NPI is 1720653942. The provider is registered as an organization entity type.

The provider's business location address is:

1159 E 200 N
AMERICAN FORK, UT
ZIP 84003-022
Phone: (888) 893-7783
Fax: (855) 631-0206

The provider's authorized official is Jerome S Tannenbaum .
The authorized official title is Ceo And Chairman Of The Board and has the following contact phone number (615) 467-0140.

The CLIA number assigned to this NPI record is 46D1059271 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/20/2021 and was last updated on 5/21/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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