Provider Demographics
NPI:1073781217
Name:BADRU, INC
Entity Type:Organization
Organization Name:BADRU, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER OF BADRU, INC
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:O
Authorized Official - Last Name:BADRU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-547-6200
Mailing Address - Street 1:PO BOX 1214
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37088-1214
Mailing Address - Country:US
Mailing Address - Phone:615-547-6200
Mailing Address - Fax:615-547-6202
Practice Address - Street 1:521 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3460
Practice Address - Country:US
Practice Address - Phone:615-547-6200
Practice Address - Fax:615-547-6202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41138207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
38146801Medicare PIN
TNI63192Medicare UPIN