Organization
GOOD SAMARITAN FAMILY WALK-IN CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA TERESA ORTEGA FNP (FNP/OWNER)
(731) 215-2277
Entity
Organization
Contact information
Practice address
1869 HIGHWAY 45 BYP, SUITE 4, JACKSON, TN 38305-2464
(731) 215-2277
(731) 215-2318
Mailing address
1869 HIGHWAY 45 BYP, SUITE 4, JACKSON, TN 38305-2464
(731) 215-2277
(731) 215-2318
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
10533
TN
261QP2300X
Primary Care Clinic/Center
Primary
10533
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1519182
—
TN
Enumeration date
11/03/2010
Last updated
11/03/2010
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