Healthcare Provider Details
I. General information
NPI: 1326181272
Provider Name (Legal Business Name): FAMILY HEALTHCARE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/14/2007
Last Update Date: 07/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
905 MAIN ST
NASHVILLE TN
37206-3609
US
IV. Provider business mailing address
905 MAIN ST
NASHVILLE TN
37206-3609
US
V. Phone/Fax
- Phone: 615-227-3000
- Fax: 615-227-5678
- Phone: 615-227-3000
- Fax: 615-227-5678
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | 3704277 |
| License Number State | TN |
VIII. Authorized Official
Name:
MARCEL
YEMBA
ELUHU
Title or Position: PRESIDENT
Credential: M.D.
Phone: 615-227-3000