BANYAN HEALTHCARE & WELLNESS CENTER LLC NPI 1942381207

NPI Information

NPI: 1942381207
Provider Name: BANYAN HEALTHCARE & WELLNESS CENTER, LLC
Classification: Clinic/Center - 261QP3300X
Entity Type: Organization

Specialization: Pain

Address:
1030 MCARTHUR ST
MANCHESTER, TN
ZIP 37355
Phone: (931) 723-7950
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BANYAN HEALTHCARE & WELLNESS CENTER, LLC is a pain clinic center in Manchester, TN. BANYAN HEALTHCARE & WELLNESS CENTER, LLC NPI is 1942381207. The provider is registered as an organization entity type.

The provider's business location address is:

1030 MCARTHUR ST
MANCHESTER, TN
ZIP 37355-453
Phone: (931) 723-7950
Fax: (931) 723-7815

The provider's authorized official is James Edward Roth .
The authorized official title is President and has the following contact phone number (615) 943-9294.

The enumeration date for this NPI number is 10/17/2006 and was last updated on 4/4/2008.

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
1	261QP3300X	Clinic/Center	Pain		TENNESSEE	Yes

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
1	3736645	MEDICARE PIN	TENNESSEE

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

NPI Synchronization or Removal

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