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General NPI Number Information
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NPI Number | 1669424685
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Entity Type | Organization
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Legal Business Name | GREENEVILLE URGENT CARE CENTER INC
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 09/06/2007
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Provider Practice Location Address
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Address Line | 1744 E ANDREW JOHNSON HWY
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City | GREENEVILLE
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State | TN
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Zip | 37745-4278
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Country | US
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Telephone | 423-636-8891
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Fax | 423-636-1732
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Provider Business Mailing Address
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Address Line | 1744 E ANDREW JOHNSON HWY
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City | GREENEVILLE
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State | TN
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Zip | 37745-4278
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Country | US
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Telephone | 423-636-8891
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. CARLYLE WALTON I
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Credential |
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Telephone | 423-639-3151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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