Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 25677 Scott Hwy, Winfield, Tennessee |
Authorized Official Name and Position | James C Lovett (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 4232864141 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
470 Industrial Ln Oneida TN 37841-6294 Ph: (423) 286-4141 | 25677 Scott Hwy Winfield TN 37892 Ph: (423) 569-8064 |
NPI Number | 1366443814 |
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Provider Enumeration Date | 08/09/2005 |
Last Update Date | 07/21/2022 |
Medicare PECOS PAC ID | 7517945678 |
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Medicare Enrollment ID | O20100624000190 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366443814 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Tennessee) | Primary |