Premier Care Medical
Clinic/Center, Urgent Care in Kodak, TN. Organization (NPI-2).
NPI number1164069084
StatusActive
Last updated in NPPESDec 10, 2019
Details
- NPI
- 1164069084
- Entity type
- Organization (NPI-2)
- Legal business name
- Premier Care Medical
- Organization subpart
- No
- Enumeration date
- Dec 10, 2019
- Certification date
- Dec 10, 2019
- Last updated
- Dec 10, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QU0200X | Clinic/Center, Urgent Care | – | – | Yes |
Practice location
3609 Outdoor Sportsman Pl Ste 7Kodak, TN 37764-1477
Phone 865-210-3452
Mailing address
3609 Outdoor Sportsman Pl Ste 7Kodak, TN 37764-1477
Phone 865-210-3452
Authorized official
Ian P Clarke
Owner
8652815922
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