Provider Demographics
NPI:1427039858
Name:NES TENNESSEE, INC.
Entity type:Organization
Organization Name:NES TENNESSEE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SERGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-377-8721
Mailing Address - Street 1:PO BOX 198733
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8733
Mailing Address - Country:US
Mailing Address - Phone:800-377-8721
Mailing Address - Fax:304-697-1155
Practice Address - Street 1:2835 HIGHWAY 231 N
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-7327
Practice Address - Country:US
Practice Address - Phone:931-685-8989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-11
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4023660OtherBCBS
TN3725810Medicaid
TN3382840Medicare PIN
TN4023660OtherBCBS
TNCG7429Medicare PIN