Provider Demographics
NPI:1538635776
Name:NASHVILLE HORMONE & INTEGRATIVE MEDICINE CENTER, LLC
Entity Type:Organization
Organization Name:NASHVILLE HORMONE & INTEGRATIVE MEDICINE CENTER, LLC
Other - Org Name:NASHVILLE HORMONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MONACO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-964-5871
Mailing Address - Street 1:1909 MALLORY LN STE 108
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8230
Mailing Address - Country:US
Mailing Address - Phone:615-964-5871
Mailing Address - Fax:615-716-1040
Practice Address - Street 1:1909 MALLORY LN STE 108
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8230
Practice Address - Country:US
Practice Address - Phone:615-964-5871
Practice Address - Fax:615-716-1040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN8901834OtherBLUE CROSS