Provider Demographics
NPI:1891292074
Name:BTDI JV, LLP
Entity Type:Organization
Organization Name:BTDI JV, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF DEVELOPMENT OFFICER & TREASUR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-620-9200
Mailing Address - Street 1:1431 PERRONE WAY
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-4244
Mailing Address - Country:US
Mailing Address - Phone:615-620-5542
Mailing Address - Fax:
Practice Address - Street 1:1750 BROAD PARK CIR S STE 300
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-7835
Practice Address - Country:US
Practice Address - Phone:615-661-9200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-12
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory