| The Grove Family Wellness Llc | |
|
4028 S Grundy Quarles Hwy Gainesboro TN 38562-5556 | |
| (931) 268-1919 | |
| (931) 268-1920 |
| Full Name | The Grove Family Wellness Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4028 S Grundy Quarles Hwy, Gainesboro, Tennessee |
| Authorized Official Name and Position | Dolores Maria Thomas (OWNER) |
| Authorized Official Contact | 9312681919 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Grove Family Wellness Llc 4028 S Grundy Quarles Hwy Gainesboro TN 38562-5556 Ph: (931) 268-1919 | The Grove Family Wellness Llc 4028 S Grundy Quarles Hwy Gainesboro TN 38562-5556 Ph: (931) 268-1919 |
| NPI Number | 1477319135 |
|---|---|
| Provider Enumeration Date | 02/21/2024 |
| Last Update Date | 06/18/2024 |
| Medicare PECOS PAC ID | 3476099102 |
|---|---|
| Medicare Enrollment ID | O20240718001273 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477319135 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Dolores M Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932536125 PECOS PAC ID: 0648407130 Enrollment ID: I20150311000166 |
Douglas Dycus Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3698 S Grundy Quarles Hwy, Gainesboro, TN 38562 Phone: 931-268-3224 Fax: 931-268-3228 | |
Gainesboro Ultimate Med Service Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 179 Buck Branch Ln, Gainesboro, TN 38562 Phone: 931-303-0012 Fax: 931-241-5444 | |