AMG-SOUTHERN TENNESSEE LLC; NPI #1619605607

Contact Information

AMG-SOUTHERN TENNESSEE LLC

1940 N JACKSON ST STE 220
TULLAHOMA, TN 37388-8256

Phone: 931-455-4616
Fax: 931-455-2362
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rural Health	261QR1300X	B4[14]	Rural Health Clinic

Indicates primary specialty

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NPI Profile & details for AMG-SOUTHERN TENNESSEE LLC

NPI Number	`1619605607`
LBN Legal business name	AMG-SOUTHERN TENNESSEE LLC
Authorized official	CHARLOTTE LAWRENCE - (SECRETARY)
Entity	Organization
Organization subpart ¹	No
Enumeration date	08/09/2022
Last updated	08/14/2025 - About 10 months ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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