Provider Demographics
NPI:1881820892
Name:FRIENDS AND FAMILY HEALTHCARE, LLC.
Entity Type:Organization
Organization Name:FRIENDS AND FAMILY HEALTHCARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:P
Authorized Official - Last Name:AGUAYO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:615-810-8440
Mailing Address - Street 1:118 HWY 70 E
Mailing Address - Street 2:SUITE 6
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-7039
Mailing Address - Country:US
Mailing Address - Phone:615-810-8440
Mailing Address - Fax:615-810-8441
Practice Address - Street 1:118 HWY 70 E
Practice Address - Street 2:SUITE 6
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-7039
Practice Address - Country:US
Practice Address - Phone:615-810-8440
Practice Address - Fax:615-810-8441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-04
Last Update Date:2010-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13099363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1514540Medicaid