Provider Demographics
NPI:1134238702
Name:TENNESSEE VALLEY CARDIOVASCULAR
Entity type:Organization
Organization Name:TENNESSEE VALLEY CARDIOVASCULAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:RHULAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-766-2118
Mailing Address - Street 1:541 W COLLEGE ST
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-5323
Mailing Address - Country:US
Mailing Address - Phone:256-766-2118
Mailing Address - Fax:256-766-2101
Practice Address - Street 1:541 W COLLEGE ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5323
Practice Address - Country:US
Practice Address - Phone:256-766-2118
Practice Address - Fax:256-766-2101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALD679Medicare PIN