Provider Demographics
NPI:1790189348
Name:BADRU, INC
Entity Type:Organization
Organization Name:BADRU, INC
Other - Org Name:ZION WELLNESS & MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:BADRU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-364-9778
Mailing Address - Street 1:PO BOX 1214
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37088-1214
Mailing Address - Country:US
Mailing Address - Phone:615-962-9011
Mailing Address - Fax:615-962-9017
Practice Address - Street 1:805 S CHURCH ST
Practice Address - Street 2:STE 20
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-4968
Practice Address - Country:US
Practice Address - Phone:615-962-9011
Practice Address - Fax:615-962-9017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-10
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD41138261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN38146803Medicare PIN