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PETRE-JO LLC NPI 1063876076


NPI Information

NPI: 1063876076
Provider Name: PETRE-JO LLC
Classification: Preferred Provider Organization - 305R00000X
Entity Type: Organization
Address:
607 W DUE WEST AVE STE 95
MADISON, TN
ZIP 37115
Phone: (615) 982-8081
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PETRE-JO LLC is a preferred provider organization in Madison, TN. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. PETRE-JO LLC NPI is 1063876076. The provider is registered as an organization entity type.

The provider's business location address is:

607 W DUE WEST AVE STE 95
MADISON, TN
ZIP 37115-415
Phone: (615) 982-8081

The provider's authorized official is Peter Konecny .
The authorized official title is Managing Member and has the following contact phone number (931) 761-0410.

The enumeration date for this NPI number is 4/6/2016 and was last updated on 4/6/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1305R00000XPreferred Provider OrganizationL000000017166TENNESSEEYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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