Provider Demographics
NPI:1912998139
Name:SPRINGCARE MEDICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:SPRINGCARE MEDICAL SUPPLIES, INC.
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EKERETTE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:UKPONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-367-6262
Mailing Address - Street 1:1161 MURFREESBORO PIKE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-2222
Mailing Address - Country:US
Mailing Address - Phone:615-367-6262
Mailing Address - Fax:615-367-6261
Practice Address - Street 1:1161 MURFREESBORO PIKE
Practice Address - Street 2:SUITE 105
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-2222
Practice Address - Country:US
Practice Address - Phone:615-367-6262
Practice Address - Fax:615-367-6261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN862332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1454961Medicaid
TN5510490001Medicare ID - Type Unspecified