Organization
PROHEALTH RURAL HEALTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAY WHITE PHD (PRESIDENT)
(615) 866-6163
Entity
Organization
Contact information
Practice address
393 WALLACE RD, SUITE 204, NASHVILLE, TN 37211-4880
(615) 591-4750
(615) 349-9875
Mailing address
PO BOX 682589, FRANKLIN, TN 37068-2589
(615) 591-4750
(615) 591-4748
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0441892
—
TN
05
—
1505616
—
TN
Enumeration date
10/03/2008
Last updated
10/15/2008
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