Provider Demographics
NPI:1659875227
Name:HARDEMAN COUNTY COMMUNITY HEALTH CENTER
Entity Type:Organization
Organization Name:HARDEMAN COUNTY COMMUNITY HEALTH CENTER
Other - Org Name:SCHOOL HEALTH CINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:COO & CFO
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:LOVELACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-658-3388
Mailing Address - Street 1:PO BOX 720
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:TN
Mailing Address - Zip Code:38008-0720
Mailing Address - Country:US
Mailing Address - Phone:731-658-3388
Mailing Address - Fax:731-659-3131
Practice Address - Street 1:445 NUCKOLLS RD
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:TN
Practice Address - Zip Code:38008-1539
Practice Address - Country:US
Practice Address - Phone:731-658-3388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARDEMAN COUNTY COMMUNITY HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health