| Servolution Health Services Inc | |
|
181 Powell Valley School Ln Speedwell TN 37870-7431 | |
| (423) 419-5070 | |
| (423) 869-0081 |
| Full Name | Servolution Health Services Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 181 Powell Valley School Ln, Speedwell, Tennessee |
| Authorized Official Name and Position | Rhonda Roark (CHAIRMAN OF BOARD) |
| Authorized Official Contact | 4234898244 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Servolution Health Services Inc 181 Powell Valley School Ln Speedwell TN 37870-7431 Ph: (423) 419-5070 | Servolution Health Services Inc 181 Powell Valley School Ln Speedwell TN 37870-7431 Ph: (423) 419-5070 |
| NPI Number | 1629330923 |
|---|---|
| Provider Enumeration Date | 06/12/2012 |
| Last Update Date | 03/10/2017 |
| Medicare PECOS PAC ID | 3072884410 |
|---|---|
| Medicare Enrollment ID | O20170803002753 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629330923 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| Provider Name | Kimberly A Langub |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457738882 PECOS PAC ID: 8325346919 Enrollment ID: I20180129000319 |
| Provider Name | Tyler Darius Meister |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1295343879 PECOS PAC ID: 9133548159 Enrollment ID: I20200924001876 |