Provider Demographics
NPI:1629136379
Name:BEDFORD FAMILY PRACTICE URGENT CARE INC.
Entity Type:Organization
Organization Name:BEDFORD FAMILY PRACTICE URGENT CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-680-8910
Mailing Address - Street 1:1612 NORTH MAIN STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-2610
Mailing Address - Country:US
Mailing Address - Phone:931-685-2022
Mailing Address - Fax:931-685-4158
Practice Address - Street 1:1612 NORTH MAIN STREET
Practice Address - Street 2:SUITE A
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-2610
Practice Address - Country:US
Practice Address - Phone:931-685-2022
Practice Address - Fax:931-685-4158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0443937Medicaid
TN443937Medicare Oscar/Certification
TNG58173Medicare UPIN
TN443937Medicare Oscar/Certification