Organization
TULLAHOMA ADVANCED CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAT L YORK LPN (OFFICE MANAGER)
(931) 393-5112
Entity
Organization
Contact information
Practice address
601 NW ATLANTIC ST, TULLAHOMA, TN 37388-3536
(931) 393-2245
(931) 393-2247
Mailing address
601 NW ATLANTIC ST, TULLAHOMA, TN 37388-3536
(931) 393-2245
(931) 393-2247
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007451
AMERIGROUP
TN
01
—
1538215942
NPI
TN
05
—
3289001
—
TN
01
—
4144439
BCBS
TN
Enumeration date
01/26/2007
Last updated
11/06/2007
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