AMG-CROCKETT, LLC; NPI #1811543929

Contact Information

AMG-CROCKETT, LLC

722 N MILITARY ST
LORETTO, TN 38469-2336

Phone: 931-853-4622
Fax: 931-853-4621
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-CROCKETT, LLC

NPI #	`1811543929`
LBN Legal business name	AMG-CROCKETT, LLC
Authorized official	LISA BRADFORD - (REVENUE CYCLE MANAGER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	08/14/2019
Last updated	02/02/2026 - About 4 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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