Provider Demographics
NPI:1578890455
Name:FAMILY URGENT CARE, LLC
Entity Type:Organization
Organization Name:FAMILY URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:FENNEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-822-2232
Mailing Address - Street 1:293 NEW SHACKLE ISLAND ROAD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075
Mailing Address - Country:US
Mailing Address - Phone:615-822-2232
Mailing Address - Fax:615-822-2234
Practice Address - Street 1:170-D EAST MAIN STREET
Practice Address - Street 2:BOX 120
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075
Practice Address - Country:US
Practice Address - Phone:615-822-2232
Practice Address - Fax:615-822-2234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN=========OtherTAX