1831323740 NPI number — HAYWOOD AFTER-HOURS CLINIC

Table of content: (NPI 1831323740)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831323740 NPI number — HAYWOOD AFTER-HOURS CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAYWOOD AFTER-HOURS CLINIC
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:
Provider Other Organization Name Type Code:
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:
1831323740
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/06/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
321 BILLINGSLY CT STE 9
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRANKLIN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37067-6445
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-778-0509
Provider Business Mailing Address Fax Number:
615-778-0209

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2555 N WASHINGTON AVE STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROWNSVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38012-1610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
731-772-0008
Provider Business Practice Location Address Fax Number:
731-772-8477
Provider Enumeration Date:
05/06/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NESMITH
Authorized Official First Name:
BRENDA
Authorized Official Middle Name:
JOYCE
Authorized Official Title or Position:
CFO/PARTNER
Authorized Official Telephone Number:
615-778-0509

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)