Healthcare Provider Details

I. General information

NPI: 1720998149
Provider Name (Legal Business Name): SYNERGY FOOD GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1239 MULLBERRY CT
MURFREESBORO TN
37130-1137
US

IV. Provider business mailing address

1239 MULLBERRY CT
MURFREESBORO TN
37130-1137
US

V. Phone/Fax

Practice location:
  • Phone: 615-890-1788
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: GREGORY DURRETT
Title or Position: CEO
Credential:
Phone: 615-890-1788