Provider Demographics
NPI:1114117298
Name:GEMM SENIOR SERVICES INC
Entity Type:Organization
Organization Name:GEMM SENIOR SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SERVICES/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLENESHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-485-9536
Mailing Address - Street 1:525 SHELBY AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-4107
Mailing Address - Country:US
Mailing Address - Phone:615-485-9536
Mailing Address - Fax:
Practice Address - Street 1:525 SHELBY AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-4107
Practice Address - Country:US
Practice Address - Phone:615-485-9536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN01045184A208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty