Organization · Type 2 NPI

Irc-Sutter Health Jackson LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Jackson, CA

NPI number 1124893615 Active

Practice location

12030 Industry Blvd
Jackson, CA 95642-9371

Fax (209) 273-3374

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	None listed

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

NPI record

NPI: 1124893615
Entity type: Organization (Type 2)
Issued: Nov 15, 2023
Last updated: Jun 8, 2026
Status: Active

Other names

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Innovative Renal Care Jackson Dialysis Center · doing business as
Innovative Renal Care Jackson Dialysis Center · doing business as

Authorized official

Mrs. Sara Anne Brady
Authorized Official
(208) 371-7878

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About NPI 1124893615

Irc-Sutter Health Jackson LLC's National Provider Identifier is 1124893615, issued on Nov 15, 2023. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Jackson, CA. The record was last updated on Jun 8, 2026.