Healthcare Provider Details

I. General information

NPI: 1497017586
Provider Name (Legal Business Name): HEALTH CARE FOR LIFE TN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2012
Last Update Date: 11/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S PERIMETER PARK DR STE 100-21
NASHVILLE TN
37211-4143
US

IV. Provider business mailing address

301 S PERIMETER PARK DR STE 100-21
NASHVILLE TN
37211-4143
US

V. Phone/Fax

Practice location:
  • Phone: 615-781-4238
  • Fax: 888-706-7798
Mailing address:
  • Phone: 615-781-4238
  • Fax: 888-706-7798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. STUART M GREENBERG
Title or Position: PARTNER/MEMBER
Credential: O.D.
Phone: 256-332-5440