=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306161898
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SAT FAMILY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/29/2010
-----------------------------------------------------
Last Update Date | 07/08/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 333 TAMIAMI TRL S STE 183
-----------------------------------------------------
City | VENICE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34285-2426
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-220-5075
-----------------------------------------------------
Fax | 941-218-0486
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 216 KRAFT ST
-----------------------------------------------------
City | CLARKSVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37040-3004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-591-2975
-----------------------------------------------------
Fax | 931-591-2983
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. SHERRY ANN TUCKER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 931-591-2975
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------