Organization
PORTLAND PRIMARY CARE LLC
Active
Parent organization
HTI HOSPITAL HOLDINGS, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
HTI HOSPITAL HOLDINGS, INC.
Authorized official
JEFF RYDBURG (VP)
(615) 373-7415
Entity
Organization
Contact information
Practice address
103 REDBUD DR, SUITE E, PORTLAND, TN 37148-1617
(615) 325-1206
(615) 325-1245
Mailing address
103 REDBUD DR, SUITE E, PORTLAND, TN 37148-1617
(615) 325-1206
(615) 325-1245
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3734188
—
TN
Enumeration date
05/26/2006
Last updated
12/11/2007
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