Healthcare Provider Details

I. General information

NPI: 1619766847
Provider Name (Legal Business Name): TRICITIES HEALTHCARE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 E MAIN BLVD
CHURCH HILL TN
37642-3312
US

IV. Provider business mailing address

1219 BARNSLEY PL
KINGSPORT TN
37660-1197
US

V. Phone/Fax

Practice location:
  • Phone: 423-256-2196
  • Fax:
Mailing address:
  • Phone: 423-256-2196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PUSHKAS GOPALAN
Title or Position: OWNER
Credential: MD
Phone: 423-381-4186