Healthcare Provider Details

I. General information

NPI: 1790189355
Provider Name (Legal Business Name): HEALTH FIRST URGENT CARE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2014
Last Update Date: 05/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6250 HIGHWAY 64 SUITE 4
OAKLAND TN
38060-5181
US

IV. Provider business mailing address

6250 HIGHWAY 64 SUITE 4
OAKLAND TN
38060-5181
US

V. Phone/Fax

Practice location:
  • Phone: 901-235-4770
  • Fax: 901-235-4771
Mailing address:
  • Phone: 901-235-4770
  • Fax: 901-235-4771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number17269
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateTN

VIII. Authorized Official

Name: MR. DARYL W MILLER
Title or Position: OWNER
Credential:
Phone: 901-235-4770