| Advance Care Medical Clarksville Tn | |
|
1469 Tiny Town Rd Clarksville TN 37042-7202 | |
| (516) 801-1552 | |
| Not Available |
| Full Name | Advance Care Medical Clarksville Tn |
|---|---|
| Speciality | Clinic/Center |
| Location | 1469 Tiny Town Rd, Clarksville, Tennessee |
| Authorized Official Name and Position | Douglas Millar (SENIOR ADVISOR) |
| Authorized Official Contact | 9176736321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advance Care Medical Clarksville Tn 3 School St Ste 303 Glen Cove NY 11542-2548 Ph: (516) 801-1552 | Advance Care Medical Clarksville Tn 1469 Tiny Town Rd Clarksville TN 37042-7202 Ph: (516) 801-1552 |
| NPI Number | 1164094819 |
|---|---|
| Provider Enumeration Date | 07/13/2021 |
| Last Update Date | 05/11/2022 |
| Medicare PECOS PAC ID | 4082092754 |
|---|---|
| Medicare Enrollment ID | O20220622002148 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164094819 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Terriest Haire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891815106 PECOS PAC ID: 0345540506 Enrollment ID: I20151120000588 |
| Provider Name | Melissa Monroe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043676422 PECOS PAC ID: 1254637721 Enrollment ID: I20160309000965 |
| Provider Name | Lavian Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053995464 PECOS PAC ID: 1658764014 Enrollment ID: I20220207001763 |
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