Basic Information
| Provider Information | |||||||||
| NPI: | 1871836148 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CARESPOT OF HERMITAGE (5225 OLD HICKORY BOULEVARD), LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CARENOW | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 742529 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303742529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727457500 | ||||||||
| FaxNumber: | 9727454336 | ||||||||
| Practice Location | |||||||||
| Address1: | 5225 OLD HICKORY BLVD | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | HERMITAGE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370762594 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6159387190 | ||||||||
| FaxNumber: | 6159387191 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2013 | ||||||||
| LastUpdateDate: | 01/26/2017 | ||||||||
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| AuthorizedOfficialLastName: | MCKINNEY | ||||||||
| AuthorizedOfficialFirstName: | RHONDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | AVP REVENUE CYCLE URGENT CARE | ||||||||
| AuthorizedOfficialTelephone: | 9729068162 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.