Provider Demographics
NPI:1841687845
Name:PAIN MD LLC
Entity type:Organization
Organization Name:PAIN MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:CARROLL
Authorized Official - Middle Name:E
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:615-435-0553
Mailing Address - Street 1:PO BOX 681789
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-1789
Mailing Address - Country:US
Mailing Address - Phone:615-503-9000
Mailing Address - Fax:
Practice Address - Street 1:144 JACK FARRAR LN
Practice Address - Street 2:STE. B
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2398
Practice Address - Country:US
Practice Address - Phone:615-503-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332900000XSuppliersNon-Pharmacy Dispensing Site