Eastlake Urgent Care

LBN: Eastlake Medical, Llc
Eastlake Urgent Care is an health care organization with primary practice located at 2500 Jacksboro Pike Ste 6 , Jacksboro TN 37757-2818. The organization recently has only one registered license in Ambulatory Health Care Facilities / Urgent Care, which is considered as the primary health care specialty. Eastlake Medical, Llc can be contacted via phone (423) 352-6500, or through Miesel, Valerie Lynn via phone (423) 352-6500.

Contact Information

Primary practice address
2500 Jacksboro Pike Ste 6 Jacksboro TN 37757-2818
Phone: (423) 352-6500
Fax: (423) 352-6501
Website:
Map and Directions
Authorized official contact:
Name: Miesel, Valerie Lynn
Phone: (423) 352-6500

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Urgent Care 261QU0200X Tennessee

Profile Details

NPI number 1467992446
LBN Legal business name Eastlake Medical, Llc
DBA Doing business as Eastlake Urgent Care
Authorized official Miesel, Valerie Lynn
Entity Organization
Organization subpart 1 No
Enumeration date Feb 24th, 2017
Last updated Jun 27th, 2019 - 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 1467992446 NPPES
Tennessee MEDICAID Q028641
Tennessee Other 6065731

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