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Organization
NWTSC,LLC
Active
Organization
NWTSC,LLC
Active
Other names
UNION CITY SURGERY CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELINDA COOPER (ADMINISTRATOR)
(731) 885-6300
Entity
Organization
Contact information
Practice address
1722 E REELFOOT AVE, STE 1, UNION CITY, TN 38261-6050
(731) 885-6300
(731) 885-6386
Mailing address
1722 E REELFOOT AVE, STE 1, UNION CITY, TN 38261-6050
(731) 885-6300
(731) 885-6386
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
123
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15982
TLC
TN
01
—
166028900
DEPT OF LABOR
TN
01
—
3151795
BLUE CROSS/TNCARE SELECT
TN
05
—
3288184
—
TN
01
—
490004765
RAILROAD MEDICARE
TN
Enumeration date
06/16/2005
Last updated
07/30/2009
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