Provider Demographics
NPI:1699038737
Name:THREE RIVERS MEDICAL CLINICS INC
Entity Type:Organization
Organization Name:THREE RIVERS MEDICAL CLINICS INC
Other - Org Name:THREE RIVERS FAMILY PRACTICE - INEZ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. DIRECTOR PHYSICIAN REV CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-221-3641
Mailing Address - Street 1:1573 MALLORY LN STE 100
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2895
Mailing Address - Country:US
Mailing Address - Phone:152-221-1400
Mailing Address - Fax:615-465-3007
Practice Address - Street 1:94 BOARDWALK
Practice Address - Street 2:SUITE 1
Practice Address - City:INEZ
Practice Address - State:KY
Practice Address - Zip Code:41224-7003
Practice Address - Country:US
Practice Address - Phone:606-298-2660
Practice Address - Fax:606-298-2662
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THREE RIVERS MEDICAL CLINICS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-22
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health