Provider Demographics
NPI:1811463185
Name:TENNESSEE RIVER URGENT CARE
Entity type:Organization
Organization Name:TENNESSEE RIVER URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NP
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MOLLOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-320-7365
Mailing Address - Street 1:707 E 2ND ST STE A
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660-3219
Mailing Address - Country:US
Mailing Address - Phone:256-320-7365
Mailing Address - Fax:256-320-7366
Practice Address - Street 1:707 E 2ND ST STE A
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-3219
Practice Address - Country:US
Practice Address - Phone:256-320-7365
Practice Address - Fax:256-320-7366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty