Provider Demographics
NPI:1861788010
Name:ASCEND MEDICAL GROUP LLC
Entity type:Organization
Organization Name:ASCEND MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OM
Authorized Official - Prefix:
Authorized Official - First Name:TAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMBROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-642-0605
Mailing Address - Street 1:212 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-5416
Mailing Address - Country:US
Mailing Address - Phone:731-642-0605
Mailing Address - Fax:731-641-4525
Practice Address - Street 1:212 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-5416
Practice Address - Country:US
Practice Address - Phone:731-642-0605
Practice Address - Fax:731-641-4525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty