Provider Demographics
NPI:1700032786
Name:ACT MEDICAL
Entity Type:Organization
Organization Name:ACT MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:TARRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-803-8253
Mailing Address - Street 1:8900 HEATHERCREST DR
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-3043
Mailing Address - Country:US
Mailing Address - Phone:865-803-8253
Mailing Address - Fax:865-947-5127
Practice Address - Street 1:8900 HEATHERCREST DR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-3043
Practice Address - Country:US
Practice Address - Phone:865-803-8253
Practice Address - Fax:865-947-5127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0187904332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies