Organization · Type 2 NPI
State of Tennessee
Federally Qualified Health Center (FQHC) · Jamestown, TN
NPI number
1740331792
Active
Practice location
240 Colonial Circle, Suite A
Jamestown, TN 38556-3924
Fax (931) 879-9938
Mailing address
1100 England Dr
Cookeville, TN 38501-0924
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Public Health or Welfare Agency | 251K00000X | ========= (TN) |
| Federally Qualified Health Center (FQHC) Primary | 261QF0400X | None listed |
Federally Qualified Health Center (FQHC): Definition to come...
About NPI 1740331792
State of Tennessee's National Provider Identifier is 1740331792, issued on Jan 16, 2007. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Jamestown, TN. The record was last updated on Jan 7, 2025.