| Dry Creek Medical Center | |
|
1826 N Main Ave Erwin TN 37650-8932 | |
| (423) 743-6135 | |
| (423) 743-0035 |
| Full Name | Dry Creek Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1826 N Main Ave, Erwin, Tennessee |
| Authorized Official Name and Position | Linda W Buck (CEO) |
| Authorized Official Contact | 4232729163 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dry Creek Medical Center Po Box 850 Rogersville TN 37857-0850 Ph: (423) 272-9163 | Dry Creek Medical Center 1826 N Main Ave Erwin TN 37650-8932 Ph: (423) 743-6135 |
| NPI Number | 1396745162 |
|---|---|
| Provider Enumeration Date | 07/22/2005 |
| Last Update Date | 10/10/2008 |
| Medicare PECOS PAC ID | 0941118111 |
|---|---|
| Medicare Enrollment ID | O20080929000714 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396745162 | NPI | - | NPPES |
| 3703868 | Other | CIGNA MEDICARE | |
| 020021000 | Other | BLACKLUNG | |
| 002 | Other | CHAMPUS PROVIDER | |
| 4122525 | Other | TN | BLUECROSS BLUESHIELD |
| 4448096 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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