Healthcare Provider Details

I. General information

NPI: 1356640940
Provider Name (Legal Business Name): CAREHERE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2011
Last Update Date: 03/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TERMINAL DR SUITE 957
NASHVILLE TN
37214-4112
US

IV. Provider business mailing address

5141 VIRGINIA WAY STE 350
BRENTWOOD TN
37027-7572
US

V. Phone/Fax

Practice location:
  • Phone: 615-275-1824
  • Fax: 615-469-5000
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ERNIE CLEVENGER
Title or Position: PRESIDENT
Credential:
Phone: 615-221-5901