Healthcare Provider Details

I. General information

NPI: 1932987724
Provider Name (Legal Business Name): ANOTHER WAY MEDICAL SERVICES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2023
Last Update Date: 03/11/2024
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 WESTGATE CIR STE 317
BRENTWOOD TN
37027-8019
US

IV. Provider business mailing address

1616 WESTGATE CIR STE 317
BRENTWOOD TN
37027-8019
US

V. Phone/Fax

Practice location:
  • Phone: 228-800-5840
  • Fax:
Mailing address:
  • Phone: 615-600-0800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. GREG BOLAN
Title or Position: COO
Credential:
Phone: 615-660-0800