Provider Demographics
NPI:1518283241
Name:TN PERFECT WALK-IN CLINIC, PLLC
Entity Type:Organization
Organization Name:TN PERFECT WALK-IN CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HENGAMEH
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-942-9810
Mailing Address - Street 1:8078 HIGHWAY 100
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-4212
Mailing Address - Country:US
Mailing Address - Phone:615-942-9810
Mailing Address - Fax:615-942-9827
Practice Address - Street 1:8078 HIGHWAY 100
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-4212
Practice Address - Country:US
Practice Address - Phone:615-942-9810
Practice Address - Fax:615-942-9827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-20
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA1014261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PENDINGMedicare PIN