Healthcare Provider Details

I. General information

NPI: 1316908429
Provider Name (Legal Business Name): MMDS OF NASHVILLE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9081 LEBANON RD
MOUNT JULIET TN
37122-5602
US

IV. Provider business mailing address

PO BOX 15268
ASHEVILLE NC
28813-0268
US

V. Phone/Fax

Practice location:
  • Phone: 615-754-7300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: JAMES BALDWIN
Title or Position: OWNER
Credential:
Phone: 615-754-7300