Renew Medical Center LLC
General Practice in Dyersburg, TN. Organization (NPI-2).
NPI number1982202750
StatusActive
Last updated in NPPESOct 14, 2020
Details
- NPI
- 1982202750
- Entity type
- Organization (NPI-2)
- Legal business name
- Renew Medical Center LLC
- Organization subpart
- No
- Enumeration date
- Oct 14, 2020
- Certification date
- Oct 14, 2020
- Last updated
- Oct 14, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
Practice location
1937 Cook StDyersburg, TN 38024-1882
Phone 731-478-6002 · Fax 731-478-6234
Mailing address
1937 Cook StDyersburg, TN 38024-1882
Phone 731-478-6002 · Fax 731-478-6234
Authorized official
Breck M Beasley
President
7314786002
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