| Lauderdale County Medical Clinic | |
|
317 Cleveland St Ripley TN 38063 | |
| (731) 221-1804 | |
| (731) 221-1880 |
| Full Name | Lauderdale County Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 317 Cleveland St, Ripley, Tennessee |
| Authorized Official Name and Position | Amber Isbell (FINANCIAL OFFICER) |
| Authorized Official Contact | 7312536690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lauderdale County Medical Clinic 710 Carl Perkins Pkwy Tiptonville TN 38063 Ph: (731) 253-6690 | Lauderdale County Medical Clinic 317 Cleveland St Ripley TN 38063 Ph: (731) 221-1804 |
| NPI Number | 1558609628 |
|---|---|
| Provider Enumeration Date | 01/24/2013 |
| Last Update Date | 01/24/2013 |
| Medicare PECOS PAC ID | 6507052073 |
|---|---|
| Medicare Enrollment ID | O20130613000689 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558609628 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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