Provider Demographics
NPI:1508074279
Name:CHURCH STREET CARE PLLC
Entity Type:Organization
Organization Name:CHURCH STREET CARE PLLC
Other - Org Name:DARRELL G ARNETT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-320-1552
Mailing Address - Street 1:1915 CHURCH ST
Mailing Address - Street 2:ONE HALF
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2203
Mailing Address - Country:US
Mailing Address - Phone:615-320-1552
Mailing Address - Fax:615-320-3820
Practice Address - Street 1:1915 CHURCH ST
Practice Address - Street 2:ONE HALF
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2203
Practice Address - Country:US
Practice Address - Phone:615-320-1552
Practice Address - Fax:615-320-3820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN015873305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1760574610OtherNPI MD
TNAA2863276OtherDEA
TNAA2863276OtherDEA
TNAA2863276OtherDEA
TN=========OtherTX ID
TN3019475Medicare ID - Type UnspecifiedINDIVIDUAL #