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Organization

PROHEALTH RURAL HEALTH SERVICES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RAY WHITE PHD (PRESIDENT)
(615) 866-6163
Entity
Organization

Contact information

Practice address
180 BEAR CREEK PIKE, COLUMBIA, TN 38401-1813
(931) 381-7567
(931) 374-9958
Mailing address
PO BOX 682589, FRANKLIN, TN 37068-2589
(615) 591-4750
(615) 591-4748

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0441893
TN
05
1505581
TN
Enumeration date
10/15/2008
Last updated
10/15/2008
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