Provider Demographics
NPI:1851864441
Name:RINOVA THE WELLNESS GROUP, PC
Entity Type:Organization
Organization Name:RINOVA THE WELLNESS GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:W
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-807-8545
Mailing Address - Street 1:314 COOL SPRINGS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-6420
Mailing Address - Country:US
Mailing Address - Phone:615-879-8935
Mailing Address - Fax:
Practice Address - Street 1:144 JACK FARRAR LN STE B
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2398
Practice Address - Country:US
Practice Address - Phone:615-879-8935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-07
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies