Organization
GERIATRICARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDA S QUILLEN GNP (OWNER)
(423) 677-2222
Entity
Organization
Contact information
Practice address
3641 MEMORIAL BLVD, KINGSPORT, TN 37664-3422
(423) 246-2411
(423) 246-8997
Mailing address
636 DORA ST, KINGSPORT, TN 37665-1016
(423) 677-2222
(423) 246-1026
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
APN6094
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3902189
—
TN
Enumeration date
09/03/2008
Last updated
09/03/2008
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