Organization
PREMIER ORTHOPAEDICS & SPORTS MEDICINE, PLC
Active
Parent organization
PREMIER ORTHOPAEDICS & SPORTS MEDICINE, PL
Other names
Hughston Clinic Orthopaedics
Organization subpart
Yes
Provider details
NPI number
Legal business name
PREMIER ORTHOPAEDICS & SPORTS MEDICINE, PL
Authorized official
AMANDA GRACE FROMKIN (DIRECTOR OF CREDENTIALING)
(706) 494-3071
Entity
Organization
Contact information
Practice address
353 NEW SHACKLE ISLAND RD, SUITE 141C, HENDERSONVILLE, TN 37075-2379
(615) 826-7171
(615) 826-7170
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 324-6661
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0922510008
MEDICARE DME
TN
05
—
3707844
—
TN
Enumeration date
11/02/2006
Last updated
10/24/2018
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