| Ascension Saint Thomas Hickman Medical Clinic | |
|
150 E Swan Street Centerville TN 37033 | |
| (931) 729-3091 | |
| (931) 729-0809 |
| Full Name | Ascension Saint Thomas Hickman Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 150 E Swan Street, Centerville, Tennessee |
| Authorized Official Name and Position | Lisa R Davis (CFO) |
| Authorized Official Contact | 6152846845 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ascension Saint Thomas Hickman Medical Clinic 300 20th Ave N Ste 403 Nashville TN 37203-5180 Ph: (615) 289-3257 | Ascension Saint Thomas Hickman Medical Clinic 150 E Swan Street Centerville TN 37033 Ph: (931) 729-3091 |
| NPI Number | 1992718688 |
|---|---|
| Provider Enumeration Date | 08/14/2006 |
| Last Update Date | 10/27/2022 |
| Medicare PECOS PAC ID | 7315855368 |
|---|---|
| Medicare Enrollment ID | O20030102000017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992718688 | NPI | - | NPPES |
| 4037834 | Other | TN | BCBS PROF |
| 4057064 | Other | TN | BLUE CROSS BLUE SHIELD |
| 0443435 | Medicaid | TN | |
| 3280569 | Other | TN | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Life Source Of Centerville Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 132a N Central Ave, Centerville, TN 37033 Phone: 931-729-4001 Fax: 931-729-4081 | |
Dermal Solutions Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 S Central Ave, Centerville, TN 37033 Phone: 931-729-0012 Fax: 931-729-0012 | |
Saint Thomas Hickman Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1518 Highway 100, Centerville, TN 37033 Phone: 931-729-3091 |