Provider Demographics
NPI:1669164232
Name:PRIMARY CARE AT PUC
Entity type:Organization
Organization Name:PRIMARY CARE AT PUC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-457-3864
Mailing Address - Street 1:155 COVEY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-6019
Mailing Address - Country:US
Mailing Address - Phone:615-472-1550
Mailing Address - Fax:615-472-1659
Practice Address - Street 1:700 OLD HICKORY BLVD STE 208
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5462
Practice Address - Country:US
Practice Address - Phone:615-457-3864
Practice Address - Fax:615-457-3876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care