COFFEE COUNTY PHYSICIAN GROUP PC NPI 1437164878

NPI Information

  • NPI: 1437164878
  • Provider Name: COFFEE COUNTY PHYSICIAN GROUP PC
  • Classification: Emergency Medicine - 207PE0004X
  • Specialization: Emergency Medical Services
  • Entity Type: Organization
  • CLIA Number: 44D0997950
  • Address: 481 INTERSTATE DR
    MANCHESTER, TN
    ZIP 37355
  • Phone: (931) 728-6354

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NPI Details

COFFEE COUNTY PHYSICIAN GROUP PC is an emergency medical services emergency medicine in Manchester, TN. The provider is an emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. COFFEE COUNTY PHYSICIAN GROUP PC NPI is 1437164878. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

481 INTERSTATE DR
MANCHESTER, TN
ZIP 37355-108
Phone: (931) 728-6354
Fax: (931) 728-6354

The provider's authorized official is Robert J Couch .
The authorized official title is Chief Executive Officer and has the following contact phone number (931) 728-6354.

The CLIA number assigned to this NPI record is 44D0997950 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/31/2006 and was last updated on 8/22/2020.

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
1207PE0004XEmergency MedicineEmergency Medical Services0000000016TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13727643MEDICAIDTENNESSEE

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: 3/30/2025

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