Provider Demographics
NPI:1750671475
Name:BREATHE AMERICA MEDICAL GROUP LLC
Entity Type:Organization
Organization Name:BREATHE AMERICA MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-665-7100
Mailing Address - Street 1:1 BURTON HILLS BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6293
Mailing Address - Country:US
Mailing Address - Phone:615-665-7100
Mailing Address - Fax:
Practice Address - Street 1:441 DONELSON PIKE
Practice Address - Street 2:SUITE 395
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-3568
Practice Address - Country:US
Practice Address - Phone:615-367-1444
Practice Address - Fax:615-367-1445
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BREATHE AMERICA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center