Healthcare Provider Details

I. General information

NPI: 1164790523
Provider Name (Legal Business Name): EQUITY HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2011
Last Update Date: 12/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

924 CALDWELL LN
NASHVILLE TN
37204-4016
US

IV. Provider business mailing address

924 CALDWELL LN
NASHVILLE TN
37204-4016
US

V. Phone/Fax

Practice location:
  • Phone: 615-250-2443
  • Fax:
Mailing address:
  • Phone: 615-250-2443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: RICHARD JUNG
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 615-250-2443