Organization
MID-SOUTH RESPICARE,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAYA BANERJEE (OWNER)
(931) 473-5477
Entity
Organization
Contact information
Practice address
1100 SMITHVILLE HWY, SUITE 138, MC MINNVILLE, TN 37110-1662
(931) 473-5477
(931) 473-6360
Mailing address
1100 SMITHVILLE HWY, SUITE 138, MC MINNVILLE, TN 37110-1662
(931) 473-5477
(931) 473-6360
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0000000505
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047731
BC/BS
—
01
—
1952357931
TENNCARE
—
05
—
3548811
—
TN
01
—
66912
CARE CENTRIX
—
Enumeration date
05/25/2006
Last updated
04/25/2024
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