Provider Demographics
NPI:1306168398
Name:CORPORATE HEALTH DEMENSIONS, INC
Entity type:Organization
Organization Name:CORPORATE HEALTH DEMENSIONS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-468-6538
Mailing Address - Street 1:205 MILLERSPRINGS CT
Mailing Address - Street 2:ATTN: CBO
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-5434
Mailing Address - Country:US
Mailing Address - Phone:888-830-4255
Mailing Address - Fax:615-296-0151
Practice Address - Street 1:151 FARMINGTON AVE.
Practice Address - Street 2:REAW
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06156
Practice Address - Country:US
Practice Address - Phone:860-273-3265
Practice Address - Fax:860-273-3272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care