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BONNELL HEALTH AND WELLNESS NPI 1629620950


NPI Information

NPI: 1629620950
Provider Name: BONNELL HEALTH AND WELLNESS

Doing Business As: BONNELL HEALTH AND WELLNESS CENTER

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 44D2173441

Address:
19 BONNELL LANE
SUITE A
CARTHAGE, TN
ZIP 38030
Phone: (618) 588-0880
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BONNELL HEALTH AND WELLNESS is a clinic center in Carthage, TN. The provider is a 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). BONNELL HEALTH AND WELLNESS NPI is 1629620950. The provider is registered as an organization entity type.
The provider Is Doing Business As Bonnell Health And Wellness Center.

The provider's business location address is:

19 BONNELL LANE
SUITE A
CARTHAGE, TN
ZIP 38030
Phone: (618) 588-0880
Fax: (615) 588-0881

The provider's authorized official is Darce Latsis .
The authorized official title is Operations Manager and has the following contact phone number (615) 588-0880.

The CLIA number assigned to this NPI record is 44D2173441 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/16/2019 and was last updated on 1/30/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.