Organization
AFFINITY REHAB AND MEDICAL SUPPLY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER MORAN (CHIEF FINANCIAL OFFICER)
(931) 964-0880
Entity
Organization
Contact information
Practice address
4937 HIGHWAY 43 N, SUITE 101, SUMMERTOWN, TN 38483-7052
(931) 964-0880
(931) 964-0886
Mailing address
4937 HIGHWAY 43 N, SUITE 101, SUMMERTOWN, TN 38483-7052
(931) 964-0880
(931) 964-0886
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053538
AMERIGROUP COMMUNITY CARE
TN
05
—
1455157
—
TN
01
—
4153548
BLUECROSS BLUESHIELD
TN
Enumeration date
01/30/2007
Last updated
11/19/2007
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