Organization
CENTER FOR ADULT HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBBIE T BREWER (DIRECTOR)
(615) 465-7626
Entity
Organization
Contact information
Practice address
1629 WOODLAWN AVE, DYERSBURG, TN 38024-2025
(731) 285-2324
(731) 285-1440
Mailing address
PO BOX 689022, PROVIDER ENROLLMENT DEPARTMENT, FRANKLIN, TN 37068-9022
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
TN
363LF0000X
Family Nurse Practitioner
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3370274
—
TN
01
—
9140162
AETNA
TN
Enumeration date
02/26/2008
Last updated
05/18/2011
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