Organization
INTENSIVE CARE CONSORTIUM INC
Active
Parent organization
INTENSIVE CARE CONSORTIUM INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTENSIVE CARE CONSORTIUM INC
Authorized official
MR. JOHN LAVERTY (VICE PRESIDENT)
(615) 507-2312
Entity
Organization
Contact information
Practice address
8383 N DAVIS HWY, PENSACOLA, FL 32514-6039
(850) 494-3212
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
(615) 372-5426
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
09/07/2021
Last updated
09/07/2021
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