Provider Demographics
NPI:1184872210
Name:MEDICOR HEALTHCARE INC
Entity type:Organization
Organization Name:MEDICOR HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCPETERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-702-6230
Mailing Address - Street 1:PO BOX 415000
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37241-5000
Mailing Address - Country:US
Mailing Address - Phone:423-702-6230
Mailing Address - Fax:423-702-6231
Practice Address - Street 1:6234 PERIMETER DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3662
Practice Address - Country:US
Practice Address - Phone:423-702-6230
Practice Address - Fax:423-702-6231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies