MEDICARE: GARLINGTON HALLER VENTURES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1720932957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARLINGTON HALLER VENTURES, LLC

Provider Business Mailing Address
First Line	:	1009 N CASTLE HEIGHTS AVE
Second Line	:
City	:	LEBANON
State	:	TN
Zip	:	37087-5627
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1009 N CASTLE HEIGHTS AVE
Second Line	:
City	:	LEBANON
State	:	TN
Zip	:	37087-5627
Country	:	US
Telephone Number	:	228-324-1261
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	TIM HALLER
Credential	:
Telephone Number	:	228-324-1261

Provider Enumeration Date	:	02/24/2026
Last Update Date	:	02/24/2026

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