| Pa Corporate Enterprises, Llp | |
|
801 S Meridian St Greenfield TN 38230-2104 | |
| (731) 235-0555 | |
| (731) 235-0559 |
| Full Name | Pa Corporate Enterprises, Llp |
|---|---|
| Speciality | Clinic/Center |
| Location | 801 S Meridian St, Greenfield, Tennessee |
| Authorized Official Name and Position | David J Wilbert (OWNER) |
| Authorized Official Contact | 7312350555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pa Corporate Enterprises, Llp 801 S Meridian St Greenfield TN 38230-2104 Ph: (731) 235-0555 | Pa Corporate Enterprises, Llp 801 S Meridian St Greenfield TN 38230-2104 Ph: (731) 235-0555 |
| NPI Number | 1518226646 |
|---|---|
| Provider Enumeration Date | 05/09/2012 |
| Last Update Date | 03/27/2013 |
| Medicare PECOS PAC ID | 3971769001 |
|---|---|
| Medicare Enrollment ID | O20120718000320 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518226646 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | TN 1396 (Tennessee) | Primary |
| 363A00000X | Physician Assistant | TN 1396 (Tennessee) | Secondary |
| Provider Name | Michael A Revelle |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295714558 PECOS PAC ID: 5496794588 Enrollment ID: I20050428000155 |
| Provider Name | Marion J Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952494643 PECOS PAC ID: 5991731556 Enrollment ID: I20050714000598 |
Mckenzie Medical Center, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1731 S Meridan Street, Greenfield, TN 38230 Phone: 731-352-7907 Fax: 833-690-3848 | |
Greenfield Family Medical Clinic, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 230 N Front St, Greenfield, TN 38230 Phone: 731-235-2271 Fax: 731-235-2323 | |
Mckenzie Medical Center Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1731 S Meridian St, Greenfield, TN 38230 Phone: 731-678-0055 Fax: 731-678-0059 |