NPIMap

Amg Hillside LLC

Organization Active NPI Obstetrics & Gynecology Physician · Pulaski, TN

NPI 1629414719 · NPPES record last updated May 15, 2013

Key facts

NPI
1629414719
Entity type
Organization (NPI type 2)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
Legal business name
AMG HILLSIDE LLC
Practice address
1255 E College St
Suite 100
Pulaski, TN 38478-4515
Phone
(931) 424-6678
Fax
(931) 424-7113
NPI assigned
May 15, 2013
Organization subpart
No

Authorized official

Name
Jess N Judy
Title
President
Phone
(615) 565-1508

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 22

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070810000665 TN Part B Supplier - Clinic/Group Practice 9436240017 Receives reassigned benefits from 55 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pulaski, TN; Lynnville, TN; Lewisburg, TN; Lawrenceburg, TN; Ardmore, TN

National Provider Directory

Tax ID family
Amg-Hillside LLC (23 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207V00000X Yes

Addresses

Primary practice location

1255 E College St
Suite 100
Pulaski, TN 38478-4515

Mailing address

PO Box 632
Pulaski, TN 38478-0632
Phone (931) 424-6678

Other names

  • Women's Complete Care Doing business as

Other providers in Pulaski, TN

All providers in Pulaski, TN · Obstetrics & Gynecology Physician in Tennessee

Sources for this page

Verify at the official NPI Registry.