| Shrinkty Medical Services, Llc | |
|
2462 Old Fort Pkwy Murfreesboro TN 37128-4163 | |
| (931) 808-7504 | |
| Not Available |
| Full Name | Shrinkty Medical Services, Llc |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 2462 Old Fort Pkwy, Murfreesboro, Tennessee |
| Authorized Official Name and Position | Joshua Davenport (OWNER) |
| Authorized Official Contact | 6157168255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shrinkty Medical Services, Llc 105 N Maple St Ste 4 Murfreesboro TN 37130-3524 Ph: (615) 716-8255 | Shrinkty Medical Services, Llc 2462 Old Fort Pkwy Murfreesboro TN 37128-4163 Ph: (931) 808-7504 |
| NPI Number | 1568190890 |
|---|---|
| Provider Enumeration Date | 08/14/2022 |
| Last Update Date | 05/01/2025 |
| Certification Date | 05/01/2025 |
| Medicare PECOS PAC ID | 4082081518 |
|---|---|
| Medicare Enrollment ID | O20221112000051 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568190890 | NPI | - | NPPES |
| Provider Name | Prasad V Kondapavuluru |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265538581 PECOS PAC ID: 5991799306 Enrollment ID: I20040409000033 |
| Provider Name | Mary E Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609016005 PECOS PAC ID: 0042369050 Enrollment ID: I20090521000647 |
| Provider Name | Louis R Lerebours |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851821649 PECOS PAC ID: 7315320231 Enrollment ID: I20220810001215 |
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