| Citizens Of Lake County For Health Care Inc | |
|
321 E Harper St Troy TN 38260 | |
| (731) 442-0956 | |
| (731) 253-6692 |
| Full Name | Citizens Of Lake County For Health Care Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 321 E Harper St, Troy, Tennessee |
| Authorized Official Name and Position | Amber Marie Isbell (CFO) |
| Authorized Official Contact | 7312536690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Citizens Of Lake County For Health Care Inc 710 Carl Perkins Pkwy Tiptonville TN 38079-1678 Ph: (731) 253-6690 | Citizens Of Lake County For Health Care Inc 321 E Harper St Troy TN 38260 Ph: (731) 442-0956 |
| NPI Number | 1619593944 |
|---|---|
| Provider Enumeration Date | 06/23/2020 |
| Last Update Date | 06/23/2020 |
| Medicare PECOS PAC ID | 6507052073 |
|---|---|
| Medicare Enrollment ID | O20200701002392 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619593944 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Allcare Medical Troy, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 316 E Harper St, Troy, TN 38260 Phone: 731-536-4624 Fax: 731-536-4905 |