1101 Primary Care, Pllc

LBN: 1101 Primary Care, Pllc
1101 Primary Care, Pllc is an health care organization with primary practice located at 1101 Neal St , Cookeville TN 38501-0901. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. 1101 Primary Care, Pllc can be contacted via phone (931) 528-7797, or through Shirley, Carolyn via phone (931) 528-7797.

Contact Information

Primary practice address
1101 Neal St Cookeville TN 38501-0901
Phone: (931) 528-7797
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Shirley, Carolyn
Phone: (931) 528-7797

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1083074587
LBN Legal business name 1101 Primary Care, Pllc
DBA Doing business as
Authorized official Shirley, Carolyn
Entity Organization
Organization subpart 1 No
Enumeration date Feb 26th, 2016
Last updated Feb 6th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083074587 NPPES
Tennessee MEDICAID Q020668

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