FAMILY CARE CLINIC LLC NPI 1780924456

NPI Information

NPI: 1780924456
Provider Name: FAMILY CARE CLINIC LLC
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 44D2020484

Address:
306 N CHANCERY ST
MCMINNVILLE, TN
ZIP 37110
Phone: (931) 474-4700
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FAMILY CARE CLINIC LLC is a rural health clinic center in Mcminnville, TN. FAMILY CARE CLINIC LLC NPI is 1780924456. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

306 N CHANCERY ST
MCMINNVILLE, TN
ZIP 37110-048
Phone: (931) 474-4700
Fax: (931) 474-4701

The provider's authorized official is Theresa Herrin Hill .
The authorized official title is Owner and has the following contact phone number (931) 474-4700.

The CLIA number assigned to this NPI record is 44D2020484 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 2/18/2013 and was last updated on 1/15/2021.

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	Primary
1	1041C0700X	Social Worker	Clinical	No
2	363LF0000X	Nurse Practitioner	Family	No
3	261QR1300X	Clinic/Center	Rural Health	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	3649680	MEDICAID	TENNESSEE
2	TN0101	OTHER	TENNESSEE	AMERICHOICE
3	01032615	OTHER	TENNESSEE	AMERIGROUP

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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