National Provider Identifier Database

COFFEE MEDICAL GROUP LLC
Rural Health


Contact Information

COFFEE MEDICAL GROUP LLC
482 INTERSTATE DR
SUITE A
MANCHESTER, TN37355-3109
Phone: 931-728-4718
Fax: 931-728-1016
Website:
Specialty Taxonomy Code
* Rural Health 261QR1300X

* Indicates primary specialty

NPI Profile & details for COFFEE MEDICAL GROUP LLC

NPI Number 1043537046
Legal business name
LBN
COFFEE MEDICAL GROUP LLC
Authorized official ROBERT COUCH - (CHIEF EXECUTIVE OFFICER)
Entity Organization
Organization subpart No
Enumeration date 04/29/2010
Last updated 02/09/2024 - About 2 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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