MEDICARE: HERBISON MEDICAL INC.

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	3336C0003X	Community/Retail Pharmacy	3815	TN
2	332BX2000X	Oxygen Equipment & Supplies (DME)	663	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487760088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HERBISON MEDICAL INC.

Provider Business Mailing Address
First Line	:	PO BOX 9
Second Line	:
City	:	MC EWEN
State	:	TN
Zip	:	37101-0009
Country	:	US
Telephone Number	:	931-582-7711
Fax Number	:

Provider Business Practice Location Address
First Line	:	124 MAIN ST
Second Line	:
City	:	MC EWEN
State	:	TN
Zip	:	37101-4590
Country	:	US
Telephone Number	:	931-582-7711
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. GEORGE ALLEN HERBISON
Credential	:
Telephone Number	:	931-582-7711

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	06/12/2012

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Directions to “HERBISON MEDICAL INC. ” Practice Location

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