Provider Demographics
NPI:1437386273
Name:CARILLON, INC.
Entity Type:Organization
Organization Name:CARILLON, INC.
Other - Org Name:CARILLON COMMUNITY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JACKSON
Authorized Official - Last Name:MCCLENDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-763-9561
Mailing Address - Street 1:1717 NORFOLK AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79416-6099
Mailing Address - Country:US
Mailing Address - Phone:806-281-6000
Mailing Address - Fax:
Practice Address - Street 1:1717 NORFOLK AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79416
Practice Address - Country:US
Practice Address - Phone:806-281-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-19
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service