Provider Demographics
NPI:1003165754
Name:ENHANCED MEDICAL SOLUTIONS
Entity Type:Organization
Organization Name:ENHANCED MEDICAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/
Authorized Official - Prefix:
Authorized Official - First Name:LAVONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGLORY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-455-2279
Mailing Address - Street 1:313 N JACKSON ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-3559
Mailing Address - Country:US
Mailing Address - Phone:931-455-2279
Mailing Address - Fax:
Practice Address - Street 1:313 N JACKSON ST
Practice Address - Street 2:SUITE 2
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-3559
Practice Address - Country:US
Practice Address - Phone:931-455-2279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN489099251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management