Basic Information
| Provider Information | |||||||||
| NPI: | 1659885986 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ENDURACARE ACUTE CARE SERVICES LLC | ||||||||
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| OtherOrganizationName: | ENDURACARE ACUTE CARE SERVICES BRANDON | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 381 RIVERSIDE DR STE 440 | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370648934 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158618755 | ||||||||
| FaxNumber: | 6154721936 | ||||||||
| Practice Location | |||||||||
| Address1: | 1392 W GOVERNMENT ST # C | ||||||||
| Address2: | |||||||||
| City: | BRANDON | ||||||||
| State: | MS | ||||||||
| PostalCode: | 390423049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6018248814 | ||||||||
| FaxNumber: | 6018248816 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2017 | ||||||||
| LastUpdateDate: | 11/22/2017 | ||||||||
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| AuthorizedOfficialLastName: | BERRELL | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | VP OF HUMAN RESOURCES | ||||||||
| AuthorizedOfficialTelephone: | 6018618755 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.