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8904 Hiwassee St Ne Charleston TN 37310-5378 | |
| (423) 810-0031 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 8904 Hiwassee St Ne, Charleston, 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 |
|---|---|
330 Seven Springs Way Brentwood TN 37027-5098 Ph: (615) 920-7000 | 8904 Hiwassee St Ne Charleston TN 37310-5378 Ph: (423) 810-0031 |
| NPI Number | 1255113486 |
|---|---|
| Provider Enumeration Date | 10/23/2023 |
| Last Update Date | 09/16/2024 |
| Medicare PECOS PAC ID | 2163490319 |
|---|---|
| Medicare Enrollment ID | O20231229000303 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255113486 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Preferred Family Medical Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9026 Hiwassee St Ne, Charleston, TN 37310 Phone: 423-665-3666 Fax: 423-584-6747 |