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Organization

FAMILY CARE CENTER LLC

Active
Other names
Westside Family Care Center
Organization subpart
No

Provider details

NPI number
Authorized official
HANNA C ILIA MD (OWNER)
(615) 666-6425
Entity
Organization

Contact information

Practice address
207 W LOCUST ST, LAFAYETTE, TN 37083-1710
(615) 666-6425
(615) 666-3261
Mailing address
10427 HIGHWAY 52 W, WESTMORELAND, TN 37186-3234
(615) 644-5832
(615) 644-5836

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
MD30470
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1205826526
NPI
TN
05
3828728
TN
01
G82303
UPIN
TN
Enumeration date
08/27/2007
Last updated
08/27/2007
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