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Organization

DOC SUPPLY OF WEST TENNESSEE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT T BALDRIDGE ATP (OWNER)
(800) 306-5160
Entity
Organization

Contact information

Practice address
201 LAKEVIEW RD, SUITE D, SOMERVILLE, TN 38068-9742
(901) 620-6900
(800) 481-1206
Mailing address
39 THREE WAY LN, SUITE A, HUMBOLDT, TN 38343-8561
(800) 306-5160
(800) 481-1206

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1014
TN
332BC3200X
Customized Equipment (DME)
1014
TN

Other

Enumeration date
03/04/2010
Last updated
12/29/2014
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