PREFERRED FAMILY MEDICAL CARE LLC NPI 1699188029

NPI Information

NPI: 1699188029
Provider Name: PREFERRED FAMILY MEDICAL CARE LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 44D2080428

Address:
9026 HIWASSEE ST NE
CHARLESTON, TN
ZIP 37310
Phone: (423) 665-3666
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PREFERRED FAMILY MEDICAL CARE LLC is a primary care clinic center in Charleston, TN. PREFERRED FAMILY MEDICAL CARE LLC NPI is 1699188029. The provider is registered as an organization entity type.

The provider's business location address is:

9026 HIWASSEE ST NE
CHARLESTON, TN
ZIP 37310-305
Phone: (423) 665-3666
Fax: (423) 584-6747

The provider's authorized official is Keith L Kidd .
The authorized official title is Ceo and has the following contact phone number (423) 665-3666.

The CLIA number assigned to this NPI record is 44D2080428 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/3/2014 and was last updated on 10/11/2021.

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 State	Primary
1	261Q00000X	Clinic/Center			No
2	261QS1200X	Clinic/Center	Sleep Disorder Diagnostic		No
3	261QP2300X	Clinic/Center	Primary Care	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	Q007277	MEDICAID	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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