ABUNDANT HEALTHCARE CLINIC LLC NPI 1982180113

NPI Information

NPI: 1982180113
Provider Name: ABUNDANT HEALTHCARE CLINIC LLC
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 44D2158063

Address:
130 SERRAL DR
GREENEVILLE, TN
ZIP 37745
Phone: (423) 638-7499
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ABUNDANT HEALTHCARE CLINIC LLC is a health service clinic center in Greeneville, TN. ABUNDANT HEALTHCARE CLINIC LLC NPI is 1982180113. The provider is registered as an organization entity type.

The provider's business location address is:

130 SERRAL DR
GREENEVILLE, TN
ZIP 37745-074
Phone: (423) 638-7499

The provider's authorized official is Merlon Kent Craft .
The authorized official title is Evp/cfo and has the following contact phone number (318) 949-5515.

The CLIA number assigned to this NPI record is 44D2158063 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/11/2018 and was last updated on 1/27/2021.

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 Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service			Yes

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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