Healthcare Provider Details

I. General information

NPI: 1376746768
Provider Name (Legal Business Name): PRIMARY CARE AND PAIN RELIEF CENTER DBA NASHVILLEHEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 11/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 PATTERSON ST STE 100
NASHVILLE TN
37203-2127
US

IV. Provider business mailing address

PO BOX 331429
NASHVILLE TN
37203
US

V. Phone/Fax

Practice location:
  • Phone: 615-467-3017
  • Fax: 615-342-0015
Mailing address:
  • Phone: 615-467-3017
  • Fax: 615-342-0015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberMD8673
License Number StateTN

VIII. Authorized Official

Name: MRS. TONYA COSBY
Title or Position: OFFICE MANAGER
Credential:
Phone: 615-849-8861