Provider Demographics
NPI:1225593056
Name:BREAKTHROUGH MEDICAL CLINIC OF TENNESSEE INC
Entity Type:Organization
Organization Name:BREAKTHROUGH MEDICAL CLINIC OF TENNESSEE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:PINYARD
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:423-722-3100
Mailing Address - Street 1:880 BOONES STATION RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-4402
Mailing Address - Country:US
Mailing Address - Phone:423-722-3100
Mailing Address - Fax:423-722-3104
Practice Address - Street 1:880 BOONES STATION RD
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37615-4402
Practice Address - Country:US
Practice Address - Phone:423-722-3100
Practice Address - Fax:423-722-3104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-06
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder