Provider Demographics
NPI:1265140446
Name:PROGRESSIVEHEALTH HEALTHSPOT, LLC
Entity type:Organization
Organization Name:PROGRESSIVEHEALTH HEALTHSPOT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF EMP MED SOLUTIONS
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:MCKINLEY
Authorized Official - Last Name:RAINBOLT
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:615-830-4081
Mailing Address - Street 1:4015 ASPEN GROVE DR UNIT 4028
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-1627
Mailing Address - Country:US
Mailing Address - Phone:615-830-4081
Mailing Address - Fax:
Practice Address - Street 1:9000 GREENBRIER PKWY NW
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35756-4453
Practice Address - Country:US
Practice Address - Phone:256-893-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROGRESSIVEHEALTH HEALTHSPOT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty