1376746768 NPI number — PRIMARY CARE AND PAIN RELIEF CENTER DBA NASHVILLEHEALTH SERVICES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376746768 NPI number — PRIMARY CARE AND PAIN RELIEF CENTER DBA NASHVILLEHEALTH SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRIMARY CARE AND PAIN RELIEF CENTER DBA NASHVILLEHEALTH SERVICES, 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:
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:
1376746768
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/14/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 331429
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:
37203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-467-3017
Provider Business Mailing Address Fax Number:
615-342-0015

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1900 PATTERSON ST STE 100
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:
37203-2127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-467-3017
Provider Business Practice Location Address Fax Number:
615-342-0015
Provider Enumeration Date:
06/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
COSBY
Authorized Official First Name:
TONYA
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
615-849-8861

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  MD8673 , 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)





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