Provider Demographics
NPI:1902872179
Name:TOWN & COUNTRY HOME MEDICAL L.L.C.
Entity Type:Organization
Organization Name:TOWN & COUNTRY HOME MEDICAL L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ERISMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-766-6766
Mailing Address - Street 1:P.O. BOX 1142
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-1142
Mailing Address - Country:US
Mailing Address - Phone:931-766-6766
Mailing Address - Fax:931-766-6986
Practice Address - Street 1:323 BRINK ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-1142
Practice Address - Country:US
Practice Address - Phone:931-766-6766
Practice Address - Fax:931-766-6986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-27
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN703332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4080003OtherBLUE CROSS BLUE SHIELD
TNM0084365OtherUNITED COMMERCIAL TRAVELE
TN1454916Medicaid
TN703OtherSTATE HEALTHCARE FACILITY
TN4080003OtherTENNCARE SELECT
TN=========TOtherBCBS OF ILLINOIS
TNM0084365OtherUNITED COMMERCIAL TRAVELE
TNE00=========OtherAETNA PROVIDER NUMBER
TN=========OtherCONTINENTAL LIFE PROVIDER
TN1454916Medicaid
TN4080003OtherTENNCARE SELECT
TN=========OtherPYRAMID PROVIDER NUMBER
TN4628430001Medicare NSC