Abundant Healthcare Clinic LLC
Clinic/Center, Health Services in Greeneville, TN. Organization (NPI-2).
NPI number1982180113
StatusActive
Last updated in NPPESJan 27, 2021
Details
- NPI
- 1982180113
- Entity type
- Organization (NPI-2)
- Legal business name
- Abundant Healthcare Clinic LLC
- Organization subpart
- No
- Enumeration date
- Jul 11, 2018
- Certification date
- Jan 27, 2021
- Last updated
- Jan 27, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QH0100X | Clinic/Center, Health Services | – | – | Yes |
Practice location
130 Serral DrGreeneville, TN 37745-3074
Phone 423-638-7499
Mailing address
2101 Highway 80Haughton, LA 71037-9488
Phone 318-949-5515 · Fax 318-949-5555
Other practice locations
6050 Dana Way Ste 200
Antioch, TN 37013-3224
Antioch, TN 37013-3224
Phone 615-641-2292
Authorized official
Merlon Kent Craft
Evp/Cfo
3189495515
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