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NPI Code Detail

MEDICARE: PUTNAM COUNTY RURAL HEALTH CLINIC, INC

MEDICARE: PUTNAM COUNTY RURAL HEALTH CLINIC, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR1300XRural Health Clinic/CenterTN

General Provider Information

NPI Number : 1316936560
Entity Type Code : Organization
Provider Name (Legal Business Name) : PUTNAM COUNTY RURAL HEALTH CLINIC, INC
Provider Business Mailing Address
First Line : PO BOX 175
Second Line :
City : BAXTER
State : TN
Zip : 38544-0175
Country : US
Telephone Number : 931-858-2116
Fax Number : 931-858-2117
Provider Business Practice Location Address
First Line : 319 BROAD ST
Second Line :
City : BAXTER
State : TN
Zip : 38544-5117
Country : US
Telephone Number : 931-858-2116
Fax Number : 931-858-2117
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MS. JANE KISSANE
Credential :
Telephone Number : 931-858-2116
Provider Enumeration Date : 10/20/2005
Last Update Date : 08/22/2020

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Directions to “PUTNAM COUNTY RURAL HEALTH CLINIC, INC ” Practice Location

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