Provider Demographics
NPI:1902850480
Name:FAMILY HEALTHCARE ASSOCIATES
Entity Type:Organization
Organization Name:FAMILY HEALTHCARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-632-3010
Mailing Address - Street 1:726 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ADAMSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38310
Mailing Address - Country:US
Mailing Address - Phone:731-632-3010
Mailing Address - Fax:731-632-3052
Practice Address - Street 1:726 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ADAMSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38310
Practice Address - Country:US
Practice Address - Phone:731-632-3010
Practice Address - Fax:731-632-3052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29254207Q00000X, 207V00000X
TNRN27447363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Not Answered207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNJT1051OtherCIGNA
TN4038058OtherBLUE CROSS
TN3158250OtherBLUE CROSS
TN3719669Medicaid
TNJT1051OtherCIGNA
R90819Medicare UPIN
TN4038058OtherBLUE CROSS
3719669Medicare ID - Type Unspecified
TN3719669Medicaid