MEDICARE: PAIN MD LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332BC3200X	Customized Equipment (DME)
2	332900000X	Non-Pharmacy Dispensing Site
3	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1841687845
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAIN MD LLC

Provider Business Mailing Address
First Line	:	PO BOX 681789
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37068-1789
Country	:	US
Telephone Number	:	615-503-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	144 JACK FARRAR LN
Second Line	:	STE. B
City	:	TULLAHOMA
State	:	TN
Zip	:	37388-2398
Country	:	US
Telephone Number	:	615-503-9000
Fax Number	:

Authorized Official
Title or Position	:	CORPORATE COUNSEL
Name	:	CARROLL E COMBS JR.
Credential	:
Telephone Number	:	615-435-0553

Provider Enumeration Date	:	04/17/2015
Last Update Date	:	10/16/2015

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Directions to “PAIN MD LLC ” Practice Location

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