Organization
CAMPBELL CUNNINGHAM TAYLOR PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RHONDA M GARRISON BILLING DEPT (CREDENTIALS COORDINATOR)
(865) 584-2127
Entity
Organization
Contact information
Practice address
628 SMITHVIEW DR, MARYVILLE, TN 37803-6100
(865) 984-7012
(865) 981-4401
Mailing address
628 SMITHVIEW DR, MARYVILLE, TN 37803-6100
(865) 984-7012
(865) 981-4401
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
MD0008625
TN
332B00000X
Durable Medical Equipment & Medical Supplies
MD0034217
TN
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
MD016011
TN
332B00000X
Durable Medical Equipment & Medical Supplies
MD021400
TN
332B00000X
Durable Medical Equipment & Medical Supplies
MD029986
TN
332B00000X
Durable Medical Equipment & Medical Supplies
OD001240
TN
332B00000X
Durable Medical Equipment & Medical Supplies
OD002250
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3371152
MEDICARE
TN
05
—
3371152
—
TN
01
—
645010002
DME
TN
Enumeration date
10/29/2009
Last updated
06/25/2019
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