Organization
SUMMIT CONVENIENT CARE AT LEBANON LLC
Active
Parent organization
HOSPITAL CORP LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOSPITAL CORP LLC
Authorized official
GARY DUNCAN (VICE PRESIDENT)
(615) 372-5135
Entity
Organization
Contact information
Practice address
100 PHYSICIANS WAY, SUITE 110, LEBANON, TN 37090-8102
(615) 449-1100
(615) 449-1150
Mailing address
100 PHYSICIANS WAY, SUITE 110, LEBANON, TN 37090-8102
(615) 449-1100
(615) 449-1150
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1511412
—
TN
01
—
4214465
BCBS
TN
01
—
DO3658
RR MEDICARE
TN
Enumeration date
07/22/2008
Last updated
05/20/2010
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