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General NPI Number Information
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NPI Number | 1821860271
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Entity Type | Organization
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Legal Business Name | CUMBERLAND RIVER MEDICAL CLINIC, LLC
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Dates
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Enumeration Date | 10/27/2023
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Last Update Date | 10/31/2023
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Provider Practice Location Address
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Address Line | 100 OLD JEFFERSON ST
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City | CELINA
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State | TN
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Zip | 38551-4040
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Country | US
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Telephone | 931-243-3576
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Fax | 931-243-5155
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Provider Business Mailing Address
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Address Line | PO BOX 2801
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City | CROSSVILLE
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State | TN
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Zip | 38557-2801
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MGR
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Name | TAMARA EROH
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Credential |
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Telephone | 931-200-2246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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