Provider Demographics
NPI:1376746768
Name:PRIMARY CARE AND PAIN RELIEF CENTER DBA NASHVILLEHEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:PRIMARY CARE AND PAIN RELIEF CENTER DBA NASHVILLEHEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:COSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-849-8861
Mailing Address - Street 1:PO BOX 331429
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203
Mailing Address - Country:US
Mailing Address - Phone:615-467-3017
Mailing Address - Fax:615-342-0015
Practice Address - Street 1:1900 PATTERSON ST STE 100
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2127
Practice Address - Country:US
Practice Address - Phone:615-467-3017
Practice Address - Fax:615-342-0015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD8673261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNB03378Medicare UPIN
TNB02721Medicare UPIN
TN3703168Medicare PIN
TNP155992Medicare UPIN