Provider Demographics
NPI:1174845861
Name:BRETTHAVEN INC.
Entity Type:Organization
Organization Name:BRETTHAVEN INC.
Other - Org Name:ALGOOD DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:BS CPHT
Authorized Official - Phone:931-537-3211
Mailing Address - Street 1:606 W MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38506-5395
Mailing Address - Country:US
Mailing Address - Phone:931-537-3211
Mailing Address - Fax:931-537-9994
Practice Address - Street 1:606 W MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38506-5395
Practice Address - Country:US
Practice Address - Phone:931-537-3211
Practice Address - Fax:931-537-9994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4640332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies