Provider Demographics
NPI:1063865962
Name:DOWELL SPRINGS MEDICAL LLC.
Entity Type:Organization
Organization Name:DOWELL SPRINGS MEDICAL LLC.
Other - Org Name:DOWELL SPRINGS MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:BOYD
Authorized Official - Last Name:DEBORD
Authorized Official - Suffix:SR
Authorized Official - Credentials:CPED, LPED, CFO
Authorized Official - Phone:423-312-7070
Mailing Address - Street 1:PO BOX 2107
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37816-2107
Mailing Address - Country:US
Mailing Address - Phone:423-581-1118
Mailing Address - Fax:423-581-1104
Practice Address - Street 1:6908 HOSPITALITY CIR STE B
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1105
Practice Address - Country:US
Practice Address - Phone:865-444-1200
Practice Address - Fax:865-862-4878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies