| Innovative Care Solutions Llc | |
|
2307 W Andrew Johnson Hwy Ste 113 Morristown TN 37814-8500 | |
| (423) 839-0720 | |
| Not Available |
| Full Name | Innovative Care Solutions Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2307 W Andrew Johnson Hwy Ste 113, Morristown, Tennessee |
| Authorized Official Name and Position | Jerramy Cantrell (OWNER) |
| Authorized Official Contact | 9317615732 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Care Solutions Llc 2307 W Andrew Johnson Hwy Ste 113 Morristown TN 37814-8500 Ph: (423) 839-0720 | Innovative Care Solutions Llc 2307 W Andrew Johnson Hwy Ste 113 Morristown TN 37814-8500 Ph: (423) 839-0720 |
| NPI Number | 1316597354 |
|---|---|
| Provider Enumeration Date | 09/11/2019 |
| Last Update Date | 12/08/2020 |
| Certification Date | 12/08/2020 |
| Medicare PECOS PAC ID | 5799199105 |
|---|---|
| Medicare Enrollment ID | O20210126003009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316597354 | NPI | - | NPPES |
| Q060972 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Robert C Allen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699739524 PECOS PAC ID: 5698671733 Enrollment ID: I20040617001076 |
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