Organization
PACIFIC PHYSICIAN SERVICES
Active
Other names
Portage Lakes Internal Medicine (DME)
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
(615) 465-7000
Entity
Organization
Contact information
Practice address
500 PORTAGE LAKES DR, STE. B, AKRON, OH 44319-2299
(330) 645-6934
Mailing address
4000 MERIDIAN BLVD, FRANKLIN, TN 37067-6325
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/24/2007
Last updated
08/24/2007
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