Organization
CENTENNIAL HEART LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOUIS JOSEPH (VICE PRESIDENT)
(615) 373-7600
Entity
Organization
Contact information
Practice address
2400 PATTERSON ST, SUITE 502, NASHVILLE, TN 37203-1562
(615) 515-1900
(615) 515-1993
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4525
(615) 372-5426
(615) 515-1993
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3736113
—
TN
01
—
DF6153
RR MEDICARE
TN
Enumeration date
12/19/2006
Last updated
07/18/2024
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