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General NPI Number Information
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NPI Number | 1912306382
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Entity Type | Organization
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Legal Business Name | OMNI COMMUNITY HEALTH
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Dates
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Enumeration Date | 08/21/2014
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Last Update Date | 09/02/2020
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Provider Practice Location Address
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Address Line | 145 THOMPSON LANE
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City | NASHVILLE
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State | TN
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Zip | 37211-2411
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Country | US
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Telephone | 615-781-0013
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Fax | 615-781-0688
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Provider Business Mailing Address
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Address Line | 301 S. PERIMETER PARK DRIVE SUITE 210
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City | NASHVILLE
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State | TN
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Zip | 37211-4128
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Country | US
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Telephone | 615-726-3603
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Fax | 615-827-0421
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MARK JUST
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Credential |
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Telephone | 615-726-3603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 13784
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License Number State | TN
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