National Provider Identifier Database

BRANCH MEDICAL CLINIC MID SOUTH
Military/U.S. Coast Guard Outpatient

The Defense Health Program or U.S. Coast Guard funded ?fixed? facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A ?fixed? facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the ?fixed? facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport.


Contact Information

BRANCH MEDICAL CLINIC MID-SOUTH
5722 INTEGRITY DR
MILLINGTON, TN38054-5021
Phone: 901-874-6100
Fax: 901-874-6103
Website:
Specialty Taxonomy Code
* Military/U.S. Coast Guard Outpatient 261QM1100X

* Indicates primary specialty

NPI Profile & details for BRANCH MEDICAL CLINIC MID-SOUTH

NPI Number 1245295971
Legal business name
LBN
BRANCH MEDICAL CLINIC MID-SOUTH
Authorized official WILLIAM CONDON - (BUMED UBO)
Entity Organization
Organization subpart Yes
Enumeration date 04/18/2006
Last updated 11/08/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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