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General NPI Number Information
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NPI Number | 1972254662
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Entity Type | Organization
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Legal Business Name | FIRSTHAND HEALTH CLINICAL OF TN
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Dates
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Enumeration Date | 01/13/2022
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Last Update Date | 01/13/2022
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Provider Practice Location Address
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Address Line | 6757 WALNUT HILLS DR
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City | BRENTWOOD
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State | TN
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Zip | 37027-7812
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Country | US
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Telephone | 781-718-5377
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Fax |
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Provider Business Mailing Address
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Address Line | 205 HUDSON ST FL 8
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City | NEW YORK
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State | NY
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Zip | 10013-1836
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Country | US
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Telephone | 781-718-5377
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Fax |
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Authorized Official
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Title or Position | TREASURER
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Name | SAMIR MALIK
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Credential |
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Telephone | 314-578-5416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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