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General NPI Number Information
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NPI Number | 1841943669
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Entity Type | Organization
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Legal Business Name | ADVANCE CARE MEDICAL TENNESSEE, INC.
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Dates
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Enumeration Date | 02/01/2022
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 6238 LEE HWY
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City | CHATTANOOGA
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State | TN
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Zip | 37421-2997
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Country | US
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Telephone | 866-668-2188
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Fax |
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Provider Business Mailing Address
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Address Line | 3 SCHOOL ST STE 303
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City | GLEN COVE
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State | NY
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Zip | 11542-2548
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Country | US
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Telephone | 866-668-2188
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE CHAIRMAN
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Name | JUSTIN SMITH
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Credential |
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Telephone | 866-668-2188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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