Healthcare Provider Details

I. General information

NPI: 1427267368
Provider Name (Legal Business Name): GREENVIEW PRIMECARE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 01/20/2022
Certification Date: 01/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 ANDREA ST SUITE 100
BOWLING GREEN KY
42104-5852
US

IV. Provider business mailing address

2000 HEALTH PARK DR STE 100
BRENTWOOD TN
37027-4692
US

V. Phone/Fax

Practice location:
  • Phone: 270-901-3454
  • Fax: 270-901-3459
Mailing address:
  • Phone: 615-372-5426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateKY
# 7
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number StateKY

VIII. Authorized Official

Name: LOUIS JOSEPH
Title or Position: VICE PRESIDENT
Credential:
Phone: 615-373-7630