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PROVIDENCE MEDICAL CLINIC LLC
NPI 1124215405
Specialist in Greenbrier, TN

Active since October 01, 2007
2354 HIGHWAY 41 S, GREENBRIER, TN 37073(615) 483-6675 Get Directions Write a Review

NPPES record last updated: April 29, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Providence Medical Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE MEDICAL CLINIC LLC (NPI 1124215405) is a healthcare organization registered as a specialist in Greenbrier, Tennessee and active in the NPI registry since October 2007. The organization lists Randy E Florendo, Owner / Provider, as its authorized official.

NPPES Registry Identity

NPI1124215405
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NamePROVIDENCE MEDICAL CLINIC LLC
Location Address2354 HIGHWAY 41 SGreenbrier, TN 37073-5510
Mailing Address172 FoxrunSpringfield, TN 37172-7334 · (615) 483-6675
Phone(615) 483-6675
Organization SubpartNo
Authorized OfficialRandy E FlorendoOwner / Provider · (615) 483-6675
Enumeration DateOctober 1, 2007
Last NPPES UpdateApril 29, 2008
✔ NPI 1124215405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
2354 HIGHWAY 41 S, Greenbrier, TN 37073
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Other Identifiers 2

Medicare PIN3370173TN
Other4159035TN · Blue Cross Blue Sheild

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISTY A WILLIAMSON PHARM D
Pharmacist
2354 HIGHWAY 41 S
GREENBRIER, TN 37073
Robertson County (615) 643-6979
GREENBRIER PHARMACY LLC
Pharmacy (Community/Retail Pharmacy)
2354 HIGHWAY 41 S
GREENBRIER, TN 37073
Robertson County (615) 643-6979

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Medical Clinic LLC's NPI number?

The NPI number for Providence Medical Clinic LLC is 1124215405. It was assigned to this organization in the NPPES registry on October 1, 2007.

Where is Providence Medical Clinic LLC located?

Providence Medical Clinic LLC is located at 2354 Highway 41 S, Greenbrier, TN 37073. The listed phone number is (615) 483-6675.

What is Providence Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Providence Medical Clinic LLC was last updated on April 29, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.