| Kcs Medical, Inc | |
|
1407 Hatcher Ln Columbia TN 38401-3535 | |
| (931) 901-0870 | |
| (931) 901-0872 |
| Full Name | Kcs Medical, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1407 Hatcher Ln, Columbia, Tennessee |
| Authorized Official Name and Position | Kelley A Scharrer (OWNER) |
| Authorized Official Contact | 9319010870 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kcs Medical, Inc 1407 Hatcher Ln Columbia TN 38401-3535 Ph: (931) 901-0870 | Kcs Medical, Inc 1407 Hatcher Ln Columbia TN 38401-3535 Ph: (931) 901-0870 |
| NPI Number | 1972987378 |
|---|---|
| Provider Enumeration Date | 07/15/2015 |
| Last Update Date | 06/19/2016 |
| Medicare PECOS PAC ID | 6002123254 |
|---|---|
| Medicare Enrollment ID | O20150921000939 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972987378 | NPI | - | NPPES |
| Q013842 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 11494 (Tennessee) | Primary |
| Provider Name | Kelley C Scharrer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528250115 PECOS PAC ID: 4284871021 Enrollment ID: I20130514000672 |
| Provider Name | Grady Bazzel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396998241 PECOS PAC ID: 9739474040 Enrollment ID: I20160825002348 |
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