Provider Demographics
NPI:1326481557
Name:CARESPOT OF HENDERSONVILLE (200 N. ANDERSON LANE), LLC
Entity Type:Organization
Organization Name:CARESPOT OF HENDERSONVILLE (200 N. ANDERSON LANE), LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAO & GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNDOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-600-4060
Mailing Address - Street 1:115 EAST PARK DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2311
Mailing Address - Country:US
Mailing Address - Phone:615-600-4075
Mailing Address - Fax:615-600-4624
Practice Address - Street 1:200 N ANDERSON LN
Practice Address - Street 2:SUITE 104
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-6934
Practice Address - Country:US
Practice Address - Phone:615-338-6178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-08
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty