| Olbhealthcare Pllc | |
|
460 Wolf View Cv Cordova TN 38018-7629 | |
| (901) 756-9058 | |
| (901) 221-2227 |
| Full Name | Olbhealthcare Pllc |
|---|---|
| Speciality | Hospitalist |
| Location | 460 Wolf View Cv, Cordova, Tennessee |
| Authorized Official Name and Position | Oran Lee Berkenstock (OWNER) |
| Authorized Official Contact | 9017569058 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Olbhealthcare Pllc 460 Wolf View Cv Cordova TN 38018-7629 Ph: (901) 756-9058 | Olbhealthcare Pllc 460 Wolf View Cv Cordova TN 38018-7629 Ph: (901) 756-9058 |
| NPI Number | 1386150530 |
|---|---|
| Provider Enumeration Date | 12/26/2017 |
| Last Update Date | 07/10/2023 |
| Medicare PECOS PAC ID | 9830445881 |
|---|---|
| Medicare Enrollment ID | O20180703003243 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386150530 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 24724 (Tennessee) | Secondary |
| 208M00000X | Hospitalist | 24724 (Tennessee) | Primary |
| Provider Name | Oran Lee Berkenstock |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1497771927 PECOS PAC ID: 2769473057 Enrollment ID: I20180705000842 |
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