Healthcare Provider Details

I. General information

NPI: 1992338644
Provider Name (Legal Business Name): PREMIER FAMILY CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2020
Last Update Date: 03/04/2021
Certification Date: 03/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9458 HIGHWAY 100
SCOTTS HILL TN
38374-6443
US

IV. Provider business mailing address

9458 HIGHWAY 100
SCOTTS HILL TN
38374-6443
US

V. Phone/Fax

Practice location:
  • Phone: 731-549-2600
  • Fax:
Mailing address:
  • Phone: 731-549-2600
  • Fax: 731-549-2166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DANNY POPE
Title or Position: PRESIDENT
Credential:
Phone: 731-549-2600