Provider Demographics
NPI:1659574077
Name:CHS MEDICAL
Entity Type:Organization
Organization Name:CHS MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICALDIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSSLIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:615-459-1944
Mailing Address - Street 1:10009 ROANOKE DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-7823
Mailing Address - Country:US
Mailing Address - Phone:615-849-9563
Mailing Address - Fax:
Practice Address - Street 1:983 NISSAN DRIVE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167
Practice Address - Country:US
Practice Address - Phone:615-459-1944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN130375261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine