Provider Demographics
NPI:1497856132
Name:SAINT THOMAS OUTPATIENT CARDIAC CATHETERIZATION CENTER, LLC
Entity Type:Organization
Organization Name:SAINT THOMAS OUTPATIENT CARDIAC CATHETERIZATION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-269-4545
Mailing Address - Street 1:4230 HARDING PIKE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2013
Mailing Address - Country:US
Mailing Address - Phone:615-846-4465
Mailing Address - Fax:615-846-4469
Practice Address - Street 1:4230 HARDING PIKE
Practice Address - Street 2:SUITE 230
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-846-4465
Practice Address - Fax:615-846-4469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3721667Medicare ID - Type Unspecified