Provider Demographics
NPI:1245445881
Name:HIGHLAND RIM ANESTHESIA, P.C.
Entity type:Organization
Organization Name:HIGHLAND RIM ANESTHESIA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:931-455-3649
Mailing Address - Street 1:PO BOX 1927
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-1927
Mailing Address - Country:US
Mailing Address - Phone:931-455-3649
Mailing Address - Fax:931-455-8678
Practice Address - Street 1:1801 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2201
Practice Address - Country:US
Practice Address - Phone:931-455-3649
Practice Address - Fax:931-455-8676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPN0000043342313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility