Provider Demographics
NPI:1427253533
Name:HIGHLAND RIM MEDICAL CENTER
Entity type:Organization
Organization Name:HIGHLAND RIM MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-433-9900
Mailing Address - Street 1:2330 THORNTON TAYLOR PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37334-3630
Mailing Address - Country:US
Mailing Address - Phone:931-433-9900
Mailing Address - Fax:931-433-9999
Practice Address - Street 1:2330 THORNTON TAYLOR PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:FAYETTEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37334-3630
Practice Address - Country:US
Practice Address - Phone:931-433-9900
Practice Address - Fax:931-433-9999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16030207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3018446Medicaid
TN124919OtherBLUE CROSS BLUE SHIELD ID
TN124919OtherBLUE CROSS BLUE SHIELD ID
TN3018446Medicare PIN