Healthcare Provider Details

I. General information

NPI: 1952367211
Provider Name (Legal Business Name): CUMBERLAND PROSTHETICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 02/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 21ST AVE N STE 2
NASHVILLE TN
37203-1855
US

IV. Provider business mailing address

329 21ST AVE N STE 2
NASHVILLE TN
37203-1855
US

V. Phone/Fax

Practice location:
  • Phone: 615-321-5611
  • Fax: 615-327-3871
Mailing address:
  • Phone: 615-321-5611
  • Fax: 615-327-3871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code156FX1700X
TaxonomyOcularist
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHERRY A RICHARDSON
Title or Position: OWNER
Credential: BCO, BADO
Phone: 615-321-5611