Provider Demographics
NPI:1639655368
Name:BUNKER HILL STAFFING URGENT CARE LLC
Entity Type:Organization
Organization Name:BUNKER HILL STAFFING URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPERATE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-528-7312
Mailing Address - Street 1:1300 BUNKER HILL RD STE B
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38506-4096
Mailing Address - Country:US
Mailing Address - Phone:931-528-7312
Mailing Address - Fax:931-528-7377
Practice Address - Street 1:1300 BUNKER HILL RD STE B
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38506
Practice Address - Country:US
Practice Address - Phone:931-528-7312
Practice Address - Fax:931-528-7377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-16
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care