Provider Demographics
NPI:1598714586
Name:WHEELCARE OF TENNESSEE LLC
Entity Type:Organization
Organization Name:WHEELCARE OF TENNESSEE LLC
Other - Org Name:MUSIC CITY MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BARTON
Authorized Official - Middle Name:
Authorized Official - Last Name:DODSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-895-2301
Mailing Address - Street 1:PO BOX 330715
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37133-0715
Mailing Address - Country:US
Mailing Address - Phone:615-895-2301
Mailing Address - Fax:615-896-2132
Practice Address - Street 1:1520 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-5511
Practice Address - Country:US
Practice Address - Phone:615-895-2301
Practice Address - Fax:615-896-2132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000480332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1452122Medicaid
TN1452122Medicaid