1144535154 NPI number — VOLUNTEER STATE URGENT CARE, PC

Table of content: (NPI 1144535154)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144535154 NPI number — VOLUNTEER STATE URGENT CARE, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VOLUNTEER STATE URGENT CARE, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NEIGHBORMD
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144535154
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/13/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3841 GREEN HILLS VILLAGE DR
Provider Second Line Business Mailing Address:
SUITE 410
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37215-2691
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-915-2890
Provider Business Mailing Address Fax Number:
615-691-7479

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5225 OLD HICKORY BLVD
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
HERMITAGE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37076
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-915-2890
Provider Business Practice Location Address Fax Number:
615-691-7479
Provider Enumeration Date:
08/13/2010

Additional Information

Authorized Official

Authorized Official Last Name:
YARBROUGH
Authorized Official First Name:
BARRY
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
615-292-0012

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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