Provider Demographics
NPI:1356773626
Name:WHITE HOUSE PAIN INSTITUTE LLC
Entity type:Organization
Organization Name:WHITE HOUSE PAIN INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:F
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:615-479-5389
Mailing Address - Street 1:491 SAGE RD N
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:WHITE HOUSE
Mailing Address - State:TN
Mailing Address - Zip Code:37188-9360
Mailing Address - Country:US
Mailing Address - Phone:931-802-6824
Mailing Address - Fax:931-802-6827
Practice Address - Street 1:491 SAGE RD N
Practice Address - Street 2:SUITE 1100
Practice Address - City:WHITE HOUSE
Practice Address - State:TN
Practice Address - Zip Code:37188-9360
Practice Address - Country:US
Practice Address - Phone:931-802-6824
Practice Address - Fax:931-802-6827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-08
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty