Basic Information
| Provider Information | |||||||||
| NPI: | 1780235564 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ACUTE CARE CLINICS OF AMERICA, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2861 | ||||||||
| Address2: | |||||||||
| City: | CROSSVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 385572861 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 S DUNCAN ST | ||||||||
| Address2: | |||||||||
| City: | JAMESTOWN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 385563009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9318795864 | ||||||||
| FaxNumber: | 9318793903 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2019 | ||||||||
| LastUpdateDate: | 03/10/2020 | ||||||||
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| AuthorizedOfficialLastName: | EROH | ||||||||
| AuthorizedOfficialFirstName: | TAMARA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING | ||||||||
| AuthorizedOfficialTelephone: | 9318795864 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.