1942502273 NPI number — ALCOHOL AND DRUG COUNCIL OF MIDDLE TENNESSEE

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 1942502273 NPI number — ALCOHOL AND DRUG COUNCIL OF MIDDLE TENNESSEE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALCOHOL AND DRUG COUNCIL OF MIDDLE TENNESSEE
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:
1942502273
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/18/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 330189
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:
37203-7501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-269-0029
Provider Business Mailing Address Fax Number:
615-269-0299

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1704 CHARLOTTE AVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37203-2972
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-269-0029
Provider Business Practice Location Address Fax Number:
615-269-0299
Provider Enumeration Date:
11/18/2010

Additional Information

Authorized Official

Authorized Official Last Name:
TRANTUM
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
615-269-0029

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  1000000005850 , 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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