Provider Demographics
NPI:1821339003
Name:REDI-MED PLUS
Entity Type:Organization
Organization Name:REDI-MED PLUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:423-715-7893
Mailing Address - Street 1:2554 DALTON PIKE SE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37323-7157
Mailing Address - Country:US
Mailing Address - Phone:423-715-7893
Mailing Address - Fax:423-473-1951
Practice Address - Street 1:1153 CANDIES CREEK RD
Practice Address - Street 2:
Practice Address - City:MC DONALD
Practice Address - State:TN
Practice Address - Zip Code:37353-5544
Practice Address - Country:US
Practice Address - Phone:423-715-7893
Practice Address - Fax:423-473-1951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000013774261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service