COLEMAN FAMILY CARE CLINIC (COLEMAN FAMILY CARE, INC) NPI 1013146992

Clinic/Center in Mcewen, TN

NPI 1013146992 Organization Clinic/Center

About COLEMAN FAMILY CARE CLINIC (COLEMAN FAMILY CARE, INC)

Coleman Family Care Clinic (coleman Family Care, Inc) is a provider established in Mcewen, Tennessee specializing in clinic/center. The NPI number of Coleman Family Care Clinic (coleman Family Care, Inc) is 1013146992 and was assigned on July 2009. The practitioner's primary taxonomy code is 261Q00000X with license number 14154 (TN). The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Coleman Family Care Clinic. The authorized official of this NPI record is Juelda Coleman (Owner)

NPI

1013146992

Provider NameCOLEMAN FAMILY CARE CLINIC (COLEMAN FAMILY CARE, INC)
Provider Location Address9437 HIGHWAY 70 EAST MCEWEN, TN 37101
Provider Mailing Address9437 HIGHWAY 70 EAST MC EWEN, TN 37101
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameCOLEMAN FAMILY CARE CLINIC
Other Name TypeDoing Business As (3)
Enumeration Date07-13-2009
Last Update Date06-18-2015


Primary Taxonomy

Taxonomy Code261Q00000X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
License No.14154
License StateTN
Taxonomy DescriptionA facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Business Address

COLEMAN FAMILY CARE CLINIC
9437 HIGHWAY 70 EAST
MCEWEN, TN
ZIP 37101
Phone: (931) 582-8820
Fax: (931) 582-8970

Get Directions


Mailing Address

COLEMAN FAMILY CARE CLINIC
9437 HIGHWAY 70 EAST
MC EWEN, TN
ZIP 37101
Phone: (931) 582-8820
Fax: (931) 582-8970



Authorized Official

Authorized Official Name JUELDA COLEMAN
Authorized Official TitleOWNER
Authorized Official Phone(931) 582-8820

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
1515234MEDICAID (05)TN
MC1965156OTHER (01)

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1245466135 JUELDA R COLEMAN APN, RN
Individual
Clinical Nurse Specialist (Family Health)9437 HIGHWAY 70 EAST
MC EWEN, TN 37101
(931) 582-8820

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.