Provider Demographics
NPI:1659716934
Name:METRO FAMILY CARE, LLC
Entity Type:Organization
Organization Name:METRO FAMILY CARE, LLC
Other - Org Name:VALOR MEDICAL LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER, CFO-COO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMAR
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, CPMA, CPCO
Authorized Official - Phone:865-212-2211
Mailing Address - Street 1:140 MARKET PLACE BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-2337
Mailing Address - Country:US
Mailing Address - Phone:865-212-2211
Mailing Address - Fax:833-314-0589
Practice Address - Street 1:140 MARKET PLACE BLVD STE E
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-2337
Practice Address - Country:US
Practice Address - Phone:865-212-2211
Practice Address - Fax:833-314-0589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X, 207Q00000X, 363LF0000X
TN40307207Q00000X, 302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No302F00000XManaged Care OrganizationsExclusive Provider OrganizationGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1533218Medicaid