Provider Demographics
NPI:1154555720
Name:TOTAL PAIN SOLUTIONS
Entity type:Organization
Organization Name:TOTAL PAIN SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRION
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-608-4995
Mailing Address - Street 1:PO BOX 1829
Mailing Address - Street 2:
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-1909
Mailing Address - Country:US
Mailing Address - Phone:877-608-4995
Mailing Address - Fax:877-608-2718
Practice Address - Street 1:6000 S EASTERN AVE
Practice Address - Street 2:BLDG I
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-3125
Practice Address - Country:US
Practice Address - Phone:205-608-4995
Practice Address - Fax:702-974-2090
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TPS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPH025143336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy