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MAIN STREET FAMILY CARE PLLC NPI 1770012676


NPI Information

NPI: 1770012676
Provider Name: MAIN STREET FAMILY CARE PLLC
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 44D2134034

Address:
211 CHURCH ST
TIPTONVILLE, TN
ZIP 38079
Phone: (731) 571-0569
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MAIN STREET FAMILY CARE PLLC is a rural health clinic center in Tiptonville, TN. MAIN STREET FAMILY CARE PLLC NPI is 1770012676. The provider is registered as an organization entity type.

The provider's business location address is:

211 CHURCH ST
TIPTONVILLE, TN
ZIP 38079-109
Phone: (731) 571-0569

The provider's authorized official is Misty C Barker .
The authorized official title is Np/owner and has the following contact phone number (731) 571-0569.

The CLIA number assigned to this NPI record is 44D2134034 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 6/6/2017 and was last updated on 10/31/2019.


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
1261QR1300XClinic/CenterRural HealthYes

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

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