Clark Family Clinic, Llc

LBN: Clark Family Clinic, Llc
Clark Family Clinic, Llc is an health care organization with primary practice located at 649B W Mcneal St , Bolivar TN 38008-2519. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Clark Family Clinic, Llc can be contacted via phone (731) 212-3324, or through Clark, Charlene E via phone (901) 500-5766.

Contact Information

Primary practice address
649B W Mcneal St Bolivar TN 38008-2519
Phone: (731) 212-3324
Fax: (731) 212-3325
Website:
Map and Directions
Authorized official contact:
Name: Clark, Charlene E MSN-APRN
Phone: (901) 500-5766

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X

Profile Details

NPI number 1801391719
LBN Legal business name Clark Family Clinic, Llc
DBA Doing business as
Authorized official Clark, Charlene E MSN-APRN
Entity Organization
Organization subpart 1 No
Enumeration date Mar 24th, 2018
Last updated Mar 24th, 2018 - about 6 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 1801391719 NPPES
Tennessee MEDICAID Q008745

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