National Provider Identifier Database

CRMC MSO SUB 1 INCORPORATED
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

CRMC MSO SUB 1, INCORPORATED
228 W. 4TH STREET
SUITE 200
COOKEVILLE, TN38501
Phone: 931-372-0405
Fax: 931-372-0463
Website:
Specialty Taxonomy Code
* Specialist 174400000X
Nurse Practitioner 363L00000X
Surgical 363AS0400X

* Indicates primary specialty

NPI Profile & details for CRMC MSO SUB 1, INCORPORATED

NPI Number 1972648319
Legal business name
LBN
CRMC MSO SUB 1, INCORPORATED
Authorized official MARILYN KEY - (CEO)
Entity Organization
Organization subpart No
Enumeration date 02/21/2007
Last updated 07/16/2024 - More than a year ago
Sole proprietor1 Not specified
Identifiers
  • TN Medicaid: 3732135

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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