1780667675 NPI number — METRO MEDICAL HOMECARE, INC.

Table of content: (NPI 1780667675)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780667675 NPI number — METRO MEDICAL HOMECARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
METRO MEDICAL HOMECARE, INC.
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:
METRO MEDICAL SUPPLY RETAIL, INC.
Provider Other Organization Name Type Code:
3
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:
1780667675
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 CUMBERLAND BND
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:
37228-1804
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-312-9880
Provider Business Mailing Address Fax Number:
615-320-5418

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1911 CHURCH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37203-2203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-329-2327
Provider Business Practice Location Address Fax Number:
615-321-9513
Provider Enumeration Date:
11/23/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TOMPKINS
Authorized Official First Name:
FLORIS
Authorized Official Middle Name:
H
Authorized Official Title or Position:
EXECUTIVE VICE PRESIDENT
Authorized Official Telephone Number:
615-312-9880

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  0000000412 , 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: 3540635 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".