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General NPI Number Information
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NPI Number | 1982356101
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Entity Type | Organization
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Legal Business Name | OAK RIDGE CLINICAL SERVICES LLC
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Dates
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Enumeration Date | 01/19/2022
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 854 MAIN ST
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City | OAK RIDGE
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State | TN
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Zip | 37830-6716
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Country | US
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Telephone | 865-482-0345
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Fax | 865-482-8814
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Provider Business Mailing Address
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Address Line | 854 MAIN ST
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City | OAK RIDGE
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State | TN
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Zip | 37830-6716
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Country | US
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Telephone | 865-482-0345
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Fax | 865-482-8814
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICIAL
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Name | SAAD AQQAD
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Credential | PHARMD
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Telephone | 678-231-9899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 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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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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