Mid State Ent, LLC

Specialist in Hendersonville, TN. Organization (NPI-2).

NPI number1164625828

StatusActive

Last updated in NPPESAug 22, 2020

Details

NPI: 1164625828
Entity type: Organization (NPI-2)
Legal business name: Mid State Ent, LLC
Organization subpart: No
Enumeration date: Jun 8, 2007
Last updated: Aug 22, 2020

Medicare and OIG

Medicare enrolled (PECOS): Not in the Medicare enrollment file
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
174400000X	Specialist	–	–	Yes

Practice location

107 Glen Oak Blvd
Suite 101
Hendersonville, TN 37075

Phone 615-822-2177 · Fax 615-822-0300

Mailing address

107 Glen Oak Blvd
Suite 101
Hendersonville, TN 37075

Phone 615-822-2177 · Fax 615-822-0300

Authorized official

Raymond B Demoville
Co-Owner
6158222177

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Specialist providers in Hendersonville, TN

All 17 Specialist providers in Hendersonville · All 1,996 providers in Hendersonville

Checking a whole list?

Paste a list of NPIs and get status, record, Medicare enrollment and OIG exclusion for each one. 100 free a day, then from $5 for 5,000. Useful for credentialing, billing and pharmacy claim checks.

Start a bulk check