Organization
UNIVITA OF TENNESSEE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS D BYRD ESQ (GENERAL COUNSEL)
(754) 777-5321
Entity
Organization
Contact information
Practice address
947 WOODLAND ST, NASHVILLE, TN 37206-3753
(615) 650-8000
(615) 724-0242
Mailing address
947 WOODLAND ST, NASHVILLE, TN 37206-3753
(615) 650-8000
(615) 724-0242
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
0000000510
TN
332BC3200X
Customized Equipment (DME)
Primary
0000000510
TN
332BX2000X
Oxygen Equipment & Supplies (DME)
0000000510
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00727207B
—
GA
05
—
009109617
—
VA
01
—
0103950
BLUECROSS BLUESHIELD
TN
05
—
1452401
—
TN
05
—
3558151
—
TN
05
—
45001641
—
KY
05
—
90262601
—
KY
Enumeration date
09/29/2005
Last updated
05/12/2015
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