COFFEE MEDICAL GROUP LLC (NPI# 1043537046) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043537046 |
| Entity Type | Organization |
| Organization Name | COFFEE MEDICAL GROUP LLC |
| Other Organization Name | MANCHESTER RURAL HEALTH CLINIC |
| Practice Address |
482 Interstate Dr Suite A Manchester TN 37355-3109 |
| Mailing Address |
482 Interstate Dr Manchester TN 37355-3109 |
| Practice Telephone | 9317284718 |
| Practice Fax Number | 9317281016 |
| Mailing Telephone | 9317284718 |
| Mailing Fax Number | 9317281016 |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2016-06-02 |
| Authorized Official Name | ROBERT J COUCH (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9317286354 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| MANCHESTER RURAL HEALTH CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063509271 | Coffee Medical Group LLC | Nursing Facility/Intermediate Care Facility | 1001 Mcarthur Drive, Manchester, TN 37355 | 2006-10-07 |
| 1013969179 | Coffee Medical Group LLC | General Acute Care Hospital | 481 Interstate Dr, Manchester, TN 37355-3108 | 2006-05-17 |
| 1114209400 | Coffee Medical Group LLC | Internal Medicine | 1001 Mcarthur St, Manchester, TN 37355-2419 | 2011-09-13 |
| 1700192028 | Coffee Medical Group LLC | Clinic/Center | 1615 Mcminnville Hwy, Manchester, TN 37355-3179 | 2010-08-24 |
| 1104995281 | Coffee Medical Group LLC | General Acute Care Hospital | 1001 Mcarthur St, Manchester, TN 37355-2419 | 2006-11-06 |
| Street Address |
482 INTERSTATE DR SUITE A |
| City | MANCHESTER |
| State | TN |
| Zip Code | 37355-3109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467489500 | Donna E Tudor | Nurse Practitioner | 482 Interstate Dr, Ste A, Manchester, TN 37355-3109 | 2006-06-26 |
| 1760926075 | Coffee Associates A Medical Management Organization, LLC | Counselor | 482 Interstate Dr, Suite D, Manchester, TN 37355-3485 | 2016-12-06 |
| 1376570424 | Albert R Brandon Jr. | Family Medicine | 482 Interstate Dr, Ste A, Manchester, TN 37355-3109 | 2006-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659857126 | Ashley Harmon Layne | Speech-Language Pathologist | 205 S Woodland St, Manchester, TN 37355 | 2018-07-17 |
| 1760996771 | Quad/med, LLC | Clinic/Center | 227 Monogard Rd, Manchester, TN 37355 | 2017-11-29 |
| 1881108157 | Sarabeth Seagreaves | Specialist/Technologist | 1700 Summer St Apt A36, Manchester, TN 37355 | 2017-11-25 |
| 1639618663 | Heather N Fesmire | Surgery | 1030 Mcarthur St., Manchester, TN 37355 | 2017-02-23 |
| 1316361561 | Charlotte Gibbs | Counselor | 482 Interstate Dr Ste D, Manchester, TN 37355 | 2014-02-08 |
| 1205258191 | Aleene Marie Falk | Social Worker | 218 Forrestwood Drive, Manchester, TN 37355 | 2014-01-10 |
| 1790067429 | Reda Lynn Lawson | Registered Nurse | 800 Parks Street, Manchester, TN 37355 | 2011-09-20 |
| 1912294117 | Patricia Beth Elliott | Nurse Practitioner | 804 Keylon Street, Manchester, TN 37355 | 2011-07-08 |
| 1427241421 | Kimberly D. Mathis | Nurse Practitioner | 1600 Mcarthur Street, Manchester, TN 37355 | 2007-08-22 |
| 1982761441 | Richard Eugene Fishbein | Orthopaedic Surgery | 102 East High Street, Manchester, TN 37355 | 2007-01-03 |
| Find all providers in zip 37355 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023649514 | Memorial Hospital Inc | Clinic/Center | 485 Memorial Dr Ste 1, Manchester, KY 40962-9111 | 2020-02-03 |
| 1851765481 | Family Health Care Associates | Clinic/Center | 359 Old Us Highway 421 Unit B, Manchester, KY 40962-7538 | 2015-11-19 |
| 1811941008 | Steven D. Spady | Clinic/Center | 509 Memorial Dr, Suite 2, Manchester, KY 40962-6195 | 2006-05-20 |
| 1477184968 | Memorial Hospital Inc | Clinic/Center | 515 Memorial Dr Ste 2, Manchester, KY 40962-9157 | 2020-02-03 |
| 1548766025 | Woodland Wellness, Inc | Clinic/Center | 115 N Woodland St, Manchester, TN 37355-1573 | 2018-04-03 |
| 1700192028 | Coffee Medical Group LLC | Clinic/Center | 1615 Mcminnville Hwy, Manchester, TN 37355-3179 | 2010-08-24 |
| 1851541197 | Memorial Hospital | Clinic/Center | 509 Memorial Dr, Suite 2, Manchester, KY 40962-6195 | 2008-09-23 |
| 1255527040 | Kathryn A Phillips | Clinic/Center | 1020 Mcarthur St, Manchester, TN 37355-2453 | 2007-09-14 |
| 1003021858 | Glenn A Davis, Md (rhc) | Clinic/Center | 1020 Mcarthur St, Manchester, TN 37355-2453 | 2007-05-14 |
| 1497887921 | Memorial Hospital, Inc. | Clinic/Center | 509 Memorial Dr, Suite 2, Manchester, KY 40962-6195 | 2007-03-10 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 37355 |
Please comment or provide details below to improve the information on COFFEE MEDICAL GROUP LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.