Provider Demographics
NPI:1780048736
Name:MEDVED & LEBED INC
Entity type:Organization
Organization Name:MEDVED & LEBED INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADFORD
Authorized Official - Middle Name:A
Authorized Official - Last Name:OTTENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-587-5800
Mailing Address - Street 1:2412 W ANDREW JOHNSON HWY
Mailing Address - Street 2:SUITE E
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-3276
Mailing Address - Country:US
Mailing Address - Phone:423-587-5800
Mailing Address - Fax:
Practice Address - Street 1:2412 W ANDREW JOHNSON HWY
Practice Address - Street 2:SUITE E
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3276
Practice Address - Country:US
Practice Address - Phone:423-587-5800
Practice Address - Fax:423-587-5818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNI000000017907253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care