CITIZENS OF LAKE COUNTY FOR HEALTH CARE INC NPI 1558609628

NPI Information

  • NPI: 1558609628
  • Provider Name: CITIZENS OF LAKE COUNTY FOR HEALTH CARE, INC
  • Classification: Clinic/Center - 261QF0400X
  • Specialization: Federally Qualified Health Center (FQHC)
  • Entity Type: Organization
  • Doing Business As: LAUDERDALE COUNTY MEDICAL CLINIC
  • CLIA Number: 44D0722147
  • Address: 317 CLEVELAND ST
    RIPLEY, TN
    ZIP 38063
  • Phone: (731) 221-1804

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NPI Details

CITIZENS OF LAKE COUNTY FOR HEALTH CARE, INC is a federally qualified health center (fqhc) clinic center in Ripley, TN. CITIZENS OF LAKE COUNTY FOR HEALTH CARE, INC NPI is 1558609628. The provider is registered as an organization entity type.
The provider Is Doing Business As Lauderdale County Medical Clinic.

The provider's business location address is:

317 CLEVELAND ST
RIPLEY, TN
ZIP 38063
Phone: (731) 221-1804
Fax: (731) 221-1880

The provider's authorized official is Amber Isbell .
The authorized official title is Financial Officer and has the following contact phone number (731) 253-6690.

The CLIA number assigned to this NPI record is 44D0722147 - federally qualified health center with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 1/24/2013 and was last updated on 1/24/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

What is NPI?

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This page was last updated on: 3/30/2025

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