Provider Demographics
NPI:1497017586
Name:HEALTH CARE FOR LIFE TN, LLC
Entity Type:Organization
Organization Name:HEALTH CARE FOR LIFE TN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:M
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:256-332-5440
Mailing Address - Street 1:301 S PERIMETER PARK DR
Mailing Address - Street 2:STE 100-21
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-4143
Mailing Address - Country:US
Mailing Address - Phone:615-781-4238
Mailing Address - Fax:888-706-7798
Practice Address - Street 1:301 S PERIMETER PARK DR
Practice Address - Street 2:STE 100-21
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-4143
Practice Address - Country:US
Practice Address - Phone:615-781-4238
Practice Address - Fax:888-706-7798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-13
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1530192Medicaid
TN1530192Medicaid