1356524615 NPI number — BELL MEDICAL CENTER PC

Table of content: (NPI 1356524615)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356524615 NPI number — BELL MEDICAL CENTER PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BELL MEDICAL CENTER PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356524615
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/10/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 110284
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37222-0284
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-732-0228
Provider Business Mailing Address Fax Number:
615-732-0231

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
393 WALLACE RD
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37211-4880
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-732-0228
Provider Business Practice Location Address Fax Number:
615-732-0231
Provider Enumeration Date:
12/10/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JUNARD
Authorized Official First Name:
FREDERICK
Authorized Official Middle Name:
OLATUNJI
Authorized Official Title or Position:
PRESIDENT / OWNER
Authorized Official Telephone Number:
615-732-0228

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  31801 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3863238 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3863238 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3894234 . This is a "CIGNA COMMERCIAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 35033 . This is a "HEALTHSPRING" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4048057 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7740358 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".