MEDICARE: CLC OF DRESDEN, LLC

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
1	314000000X	Skilled Nursing Facility	0000000280	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336139088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLC OF DRESDEN, LLC

Provider Business Mailing Address
First Line	:	PO BOX 769
Second Line	:
City	:	DRESDEN
State	:	TN
Zip	:	38225-0769
Country	:	US
Telephone Number	:	731-364-2450
Fax Number	:	731-364-5533

Provider Business Practice Location Address
First Line	:	897 EVERGREEN ST
Second Line	:
City	:	DRESDEN
State	:	TN
Zip	:	38225-2305
Country	:	US
Telephone Number	:	731-364-2450
Fax Number	:	731-364-5533

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. DOUGLAS M. WRIGHT JR.
Credential	:
Telephone Number	:	662-680-3148

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	01/28/2008

Similar Medicare Providers

1942457395 — MS. KAREN MARIE DELMONT COTA
Practice Location Address:

897 EVERGREEN ST
DRESDEN, TN
38225-2305

Practice Phone: 731-364-2450
Practice Fax: 731-364-9699

1144477662 — MRS. LINDA JONELLE MCNEELY PTA
Practice Location Address:

897 EVERGREEN ST
DRESDEN, TN
38225-2305

Practice Phone: 731-364-2450
Practice Fax: 731-364-9699

1124418967 — MS. KATHRINE DUNLAP
Practice Location Address:

897 EVERGREEN ST
DRESDEN, TN
38225-2305

Practice Phone: 731-514-3841
Practice Fax:

1225501141 — KARA WALLS COTA
Practice Location Address:

897 EVERGREEN ST
DRESDEN, TN
38225-2305

Practice Phone: 731-364-2450
Practice Fax:

1932101698 — DR. AMY ELIZABETH MALLON PHARM.D
Practice Location Address:

120 DEER RUN DR
DRESDEN, TN
38225-1837

Practice Phone: 731-364-5008
Practice Fax:

1003800616 — PHYLLIS ANN TAYLOR APNC
Practice Location Address:

8598 HIGHWAY 22
DRESDEN, TN
38225-2308

Practice Phone: 731-364-5675
Practice Fax: 731-364-2870

Directions to “CLC OF DRESDEN, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.