Provider Demographics
NPI:1255992418
Name:TENNESSEE BRACE AND MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:TENNESSEE BRACE AND MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-438-2777
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37334-0249
Mailing Address - Country:US
Mailing Address - Phone:931-438-2777
Mailing Address - Fax:931-438-2778
Practice Address - Street 1:12819 HIGHWAY 231 431 N STE B
Practice Address - Street 2:
Practice Address - City:HAZEL GREEN
Practice Address - State:AL
Practice Address - Zip Code:35750-8629
Practice Address - Country:US
Practice Address - Phone:256-693-7590
Practice Address - Fax:256-693-7586
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TENNESSEE BRACE AND MEDICAL SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-27
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL2020OtherALABAMA STATE BOARD OF PHARMACY
AL1538OtherALABAMA BOARD OF HOME MEDICAL EQUIPMENT SERVICES PROVIDERS