MEDICARE: PREMIER INTERNAL MEDICINE OF GILES COUNTY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364SF0001X	Family Health Clinical Nurse Specialist	20382	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20382	OTHER	TN	APN

General Provider Information

NPI Number	:	1407224660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER INTERNAL MEDICINE OF GILES COUNTY

Provider Business Mailing Address
First Line	:	1119 E COLLEGE ST
Second Line	:	SUITE 1
City	:	PULASKI
State	:	TN
Zip	:	38478-4563
Country	:	US
Telephone Number	:	931-207-8630
Fax Number	:	931-207-8629

Provider Business Practice Location Address
First Line	:	1119 E COLLEGE ST
Second Line	:	SUITE 1
City	:	PULASKI
State	:	TN
Zip	:	38478-4563
Country	:	US
Telephone Number	:	931-207-8630
Fax Number	:	931-207-8629

Authorized Official
Title or Position	:	OWNER,MD
Name	:	DR. CLEMENT O ALUYI
Credential	:	MD
Telephone Number	:	931-207-8630

Provider Enumeration Date	:	09/04/2015
Last Update Date	:	09/04/2015

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Practice Location Address:

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