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General NPI Number Information
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NPI Number | 1760680284
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Entity Type | Organization
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Legal Business Name | MEDICAL DIRECT CLUB, LLC
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 09/24/2015
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Provider Practice Location Address
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Address Line | 2026 LINDELL AVE
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City | NASHVILLE
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State | TN
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Zip | 37203-5509
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Country | US
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Telephone | 800-945-0066
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Fax | 615-628-0453
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Provider Business Mailing Address
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Address Line | 2026 LINDELL AVE
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City | NASHVILLE
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State | TN
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Zip | 37203-5509
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Country | US
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Telephone | 800-945-0066
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Fax | 615-628-0453
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Authorized Official
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Title or Position | CEO/OWNER
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Name | BRADFORD GULMI
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Credential |
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Telephone | 800-945-0066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 154329
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License Number State | TN
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