QUALLS HARBIN FAMILY MEDICINE LLC (NPI# 1538671631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538671631 |
| Entity Type | Organization |
| Organization Name | QUALLS HARBIN FAMILY MEDICINE LLC |
| Other Organization Name | HOMETOWN HEALTH CLINIC LLC |
| Practice Address |
255 Riverside Drive Savannah TN 38372 |
| Mailing Address |
Po Box 445 Savannah TN 38372-0445 |
| Practice Telephone | 7314383765 |
| Practice Fax Number | 7314383767 |
| Mailing Telephone | 7314383765 |
| Mailing Fax Number | 7314383767 |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2020-03-25 |
| Authorized Official Name | LAUREN HARBIN (FNP/OWNER) |
| Authorized Official Telephone | 7314383765 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APN0000021321 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q032778 | 05 | |
| TN | Q025188 | 05 |
| Other Name | Type Code |
|---|---|
| Hometown Health Clinic LLC | Former Legal Business Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 557 Pickwick St, Savannah, TN 383723082 | 2568566215 | |
| 255 Riverside Drive, Savannah, TN 38372 | 7314383765 | 7314383767 |
| Street Address |
255 RIVERSIDE DRIVE |
| City | SAVANNAH |
| State | TN |
| Zip Code | 38372 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891282950 | Sherry Ann Schoonover | Pharmacist | 175 Ji Bell Lane, Savannah, TN 38372 | 2018-04-15 |
| 1912215500 | John D. Lay Md | Family Medicine | 855 Wayne Rd Ste B, Savannah, TN 38372 | 2010-09-17 |
| 1285942144 | David Allen Carroll | Pharmacist | 835 Pickwick Street, Savannah, TN 38372 | 2010-09-14 |
| 1972810349 | Teresa Carol Williams | Pharmacist | Kroger At 775 Pickwick Rd, Savannah, TN 38372 | 2010-09-08 |
| 1619128089 | Robert L. Ginn | Dietitian, Registered | 935 Wayne Rd., Savannah, TN 38372 | 2008-10-03 |
| 1821246786 | Delca Sue Rickman | Social Worker | 765 Florence Rd., Savannah, TN 38372 | 2008-09-04 |
| 1215119102 | Grimes - Bevis Chiropractic, Pllc | Chiropractor | 1940 Pickwick St., South, Savannah, TN 38372 | 2007-12-03 |
| 1851593594 | Melanie A Reaves Pllc | Nurse Practitioner | 1440 Pickwick St, Savannah, TN 38372 | 2007-06-04 |
| 1730300690 | William F. Conway, Md, Inc | Internal Medicine | 855 Wayne Road, Suite A1, Savannah, TN 38372 | 2007-05-01 |
| 1477603629 | State of Tennessee | Public Health or Welfare | 1920 Pickwick Street, Savannah, TN 38372 | 2007-01-11 |
| Find all providers in zip 38372 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093316820 | Odyne Rose Lacossiere-dorvilus | Nurse Practitioner | 30 Myrtlewood Dr, Savannah, GA 31405-1024 | 2020-11-06 |
| 1952900383 | Micaiah Mitchell | Nurse Practitioner | 10612 Middleground Rd Apt 513, Savannah, GA 31419-1268 | 2020-10-17 |
| 1104424712 | Yolanda Michelle Miller | Nurse Practitioner | 1651 Mckinnon Dr, Savannah, GA 31404-2319 | 2020-10-15 |
| 1730795386 | Shanika Graham | Nurse Practitioner | 2330 Coakley St, Savannah, GA 31404-4947 | 2020-09-18 |
| 1508479775 | Tonya L Creasy | Nurse Practitioner | 170 Barker Dr, Savannah, TN 38372-8419 | 2020-08-28 |
| 1356952394 | Elizabeth Woods Hammond | Nurse Practitioner | 107 W Liberty St Apt 6, Savannah, GA 31401-3965 | 2020-08-13 |
| 1740898915 | Bryan S Christain | Nurse Practitioner | 340 Hodgson Ct Ste 2, Savannah, GA 31406-1523 | 2020-07-14 |
| 1841814753 | Billie Sweeney | Nurse Practitioner | 134 Horse Creek Rd, Savannah, TN 38372-2984 | 2020-06-05 |
| 1609401140 | Malika Anderson Batie | Nurse Practitioner | 1632 Cloverdale Dr, Savannah, GA 31415-7814 | 2020-03-05 |
| 1760017206 | Evelia Johnsen | Nurse Practitioner | 11702 Mercy Blvd Ste 2g, Savannah, GA 31419-1777 | 2020-03-05 |
| Find all providers in SAVANNAH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.