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Organization

PHILLIP L & CHARLOTTE C DENNISON PTRS

Active
Other names
SCOOTER UNLIMITED, JACKSON MEDICAL SUPPLY, LYMPHEDEMA TREATMENT COMPAN
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PHILLIP L DENNISON (OWNER)
(731) 664-7879
Entity
Organization

Contact information

Practice address
110 CARRIAGE HOUSE DR, JACKSON, TN 38305-3938
(731) 664-7879
(731) 664-7810
Mailing address
110 CARRIAGE HOUSE DR, JACKSON, TN 38305-3938
(731) 664-7879
(731) 664-7810

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1454677
TN
01
4083665
BCBS
TN
Enumeration date
10/16/2006
Last updated
01/11/2013
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