| Vip Midsouth, Llc | |
|
426 22nd Ave E Springfield TN 37172-3711 | |
| (615) 384-0600 | |
| Not Available |
| Full Name | Vip Midsouth, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 426 22nd Ave E, Springfield, Tennessee |
| Authorized Official Name and Position | Jeffrey P White (PRESIDENT) |
| Authorized Official Contact | 6153433509 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vip Midsouth, Llc 3841 Green Hills Village Dr Ste 200 Nashville TN 37215-2691 Ph: () - | Vip Midsouth, Llc 426 22nd Ave E Springfield TN 37172-3711 Ph: (615) 384-0600 |
| NPI Number | 1528641859 |
|---|---|
| Provider Enumeration Date | 05/04/2021 |
| Last Update Date | 03/31/2022 |
| Medicare PECOS PAC ID | 1759272982 |
|---|---|
| Medicare Enrollment ID | O20210707000772 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528641859 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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