Provider Demographics
NPI:1609955046
Name:WOOLFORK ENTERPRISES, INC
Entity type:Organization
Organization Name:WOOLFORK ENTERPRISES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:CANONGE
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-223-7700
Mailing Address - Street 1:739 PRESIDENT PL STE 140
Mailing Address - Street 2:PHYSCIAN PLAZA II
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6845
Mailing Address - Country:US
Mailing Address - Phone:615-223-7700
Mailing Address - Fax:615-223-7722
Practice Address - Street 1:739 PRESIDENT PL STE 140
Practice Address - Street 2:PHYSCIAN PLAZA II
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6845
Practice Address - Country:US
Practice Address - Phone:615-223-7700
Practice Address - Fax:615-223-7722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center