Provider Demographics
NPI:1417390642
Name:CARESPOT OF LEBANON 1705 WEST MAIN STREET LLC
Entity Type:Organization
Organization Name:CARESPOT OF LEBANON 1705 WEST MAIN STREET LLC
Other - Org Name:CARENOW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AVP REVENUE CYCLE URGENT CARE
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-906-8162
Mailing Address - Street 1:PO BOX 742535
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-2535
Mailing Address - Country:US
Mailing Address - Phone:972-745-7500
Mailing Address - Fax:972-745-4336
Practice Address - Street 1:1705 W MAIN ST
Practice Address - Street 2:SUITE 211
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3193
Practice Address - Country:US
Practice Address - Phone:615-938-7171
Practice Address - Fax:615-466-9399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-08
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty