| |
2118 Cowan Hwy Winchester TN 37398-2637 | |
(931) 962-4040 | |
(931) 962-2277 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2118 Cowan Hwy, Winchester, Tennessee |
Authorized Official Name and Position | Charlotte Lawrence (SECRETARY) |
Authorized Official Contact | 6159207000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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330 Seven Springs Way Brentwood TN 37027-5098 Ph: (615) 920-7000 | 2118 Cowan Hwy Winchester TN 37398-2637 Ph: (931) 962-4040 |
NPI Number | 1063140051 |
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Provider Enumeration Date | 08/09/2022 |
Last Update Date | 09/14/2024 |
Medicare PECOS PAC ID | 5991765943 |
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Medicare Enrollment ID | O20220829002642 |
Identifier | Type | State | Issuer |
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1063140051 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |