| |
631 Rb Wilson Dr Huntingdon TN 38344-1727 | |
(731) 986-4461 | |
Not Available |
Full Name | |
---|---|
Speciality | Psychiatric Unit |
Location | 631 Rb Wilson Dr, Huntingdon, Tennessee |
Authorized Official Name and Position | Gregory M Duckett (SR VP / CLO) |
Authorized Official Contact | 9012275233 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
350 N Humphreys Blvd Memphis TN 38120-2177 Ph: (731) 986-4461 | 631 Rb Wilson Dr Huntingdon TN 38344-1727 Ph: (731) 986-4461 |
NPI Number | 1013324425 |
---|---|
Provider Enumeration Date | 07/17/2014 |
Last Update Date | 10/01/2020 |
Certification Date | 10/01/2020 |
Medicare PECOS PAC ID | 4082509757 |
---|---|
Medicare Enrollment ID | O20140912000691 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013324425 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
273R00000X | Psychiatric Unit | 0000000010 (Tennessee) | Primary |