SANDERLING RENAL SERVICES OF HOLDENVILLE (NPI# 1124377460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124377460 |
| Entity Type | Organization |
| Organization Name | SANDERLING RENAL SERVICES OF HOLDENVILLE |
| Other Organization Name | SANDERLING DIALYSIS CENTER OF HOLDENVILLE |
| Practice Address |
102 Crestview St Holdenville OK 74848-2844 |
| Mailing Address |
511 Union Street Suite 1800 Nashville TN 37219 |
| Practice Telephone | 6154670140 |
| Mailing Telephone | 6154670140 |
| Mailing Fax Number | 6152590693 |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2012-10-01 |
| Authorized Official Name | DR. JEREOME S TANNENBAUM (ADMINISTRATOR) |
| Authorized Official Telephone | 6154670140 |
| Authorized Official Credential | M.D.,PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Sanderling Dialysis Center of Holdenville | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | SANDERLING RENAL SERVICES OF HOLDENVILLE, LLC | 2402 E 44th Pl, Tulsa, OK 74105 |
| Street Address |
102 CRESTVIEW ST |
| City | HOLDENVILLE |
| State | OK |
| Zip Code | 74848-2844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790276160 | Corner Clinic Aprn-cnp Pllc | Clinic/Center | 201 N Hinkley, Holdenville, OH 74848 | 2018-05-22 |
| 1063948230 | Savannah Ione Hartwick | Personal Emergency Response Attendant | 400 Crestview Dr., Holdenville, OK 74848 | 2017-05-10 |
| 1568910297 | Alicia Rose Gosey | Nurse Practitioner | 1011 N Hinkley St, Holdenville, OK 74848 | 2016-09-11 |
| 1649611278 | Sooner Health Services IIi, Inc. | Home Health | 106 N Broadway, Holdenville, OK 74848 | 2013-07-11 |
| 1275852089 | Jennifer Michele Gaines | Counselor | 117 Rogers Drive, Holdenville, OK 74848 | 2010-05-19 |
| 1497975528 | Gloria Buenrostro Turner | Physical Therapist | Therapy Care Outpatient PC, 317 E 8th St, Holdenville, OK 74848 | 2007-04-30 |
| 1215075528 | Therapy Care Outpatient PC | Physical Therapist | 317 E 8th Street, Holdenville, OK 74848 | 2007-02-01 |
| 1285724732 | Heritage Village Nursing Center, LLC | Skilled Nursing Facility | 801 Highway #48, Holdenville, OK 74848 | 2006-10-13 |
| 1861484776 | Joseph Omer Lavalley | Dentist | 300 E Hwy, Holdenville, OK 74848 | 2005-08-17 |
| 1699150052 | Stephanie Keesee | Nurse Practitioner | 201 N Hinckley St, Holdenville, OK 74848 | 2015-07-28 |
| Find all providers in zip 74848 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043820111 | Midtown Home Dialysis LLC | Clinic/Center | 621 Nw 6th St, Oklahoma City, OK 73102-1203 | 2020-08-04 |
| 1750905733 | Bio Medical Applications of Oklahoma Inc | Clinic/Center | 324 Nw J A Richardson Loop, Ada, OK 74820-2017 | 2020-06-04 |
| 1346879640 | Fresenius Medical Care Okcd, LLC | Clinic/Center | 3012 Nw 150th St, Oklahoma City, OK 73134-2030 | 2020-04-07 |
| 1710539424 | Fresenius Medical Care Tulsa, LLC | Clinic/Center | 9310 East 91st Street, Tulsa, OK 74133 | 2019-07-12 |
| 1487206595 | Fresenius Medical Care Tulsa, LLC | Clinic/Center | 215 S Brady St, Claremore, OK 74017-5081 | 2019-07-10 |
| 1104387711 | Total Renal Care, Inc. | Clinic/Center | 2 E Clark Bass Blvd Ste 101, Mcalester, OK 74501-4210 | 2019-03-27 |
| 1124509245 | Renal Treatment Centers West Inc | Clinic/Center | 6917 N May Ave, Oklahoma City, OK 73116-3238 | 2018-08-27 |
| 1811401631 | Fresenius Medical Care Tulsa, LLC | Clinic/Center | 5230 S Mingo Rd, Tulsa, OK 74146 | 2017-12-01 |
| 1356881346 | Macab Dialysis LLC | Clinic/Center | 204 S Van Buren St, Enid, OK 73703-5812 | 2017-02-24 |
| 1013455336 | Fresenius Medical Care Moore, LLC | Clinic/Center | 450 N Eastern Ave., Moore, OK 73160-5833 | 2017-02-07 |
| Find all providers with the same taxonomy | ||||
| City | HOLDENVILLE |
| Zip Code | 74848 |
Please comment or provide details below to improve the information on SANDERLING RENAL SERVICES OF HOLDENVILLE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.