HARDEMAN COUNTY COMMUNITY HEALTH CENTER (NPI# 1861468340) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861468340 |
| Entity Type | Organization |
| Organization Name | HARDEMAN COUNTY COMMUNITY HEALTH CENTER |
| Practice Address |
629 Nuckolls Rd Bolivar TN 38008-1599 |
| Mailing Address |
Po Box 720 Bolivar TN 38008-0720 |
| Practice Telephone | 7316583388 |
| Practice Fax Number | 7316584079 |
| Mailing Telephone | 7316583388 |
| Mailing Fax Number | 7316584079 |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2008-04-30 |
| Authorized Official Name | MARY HEINZEN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7316593114 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 4448210 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659875227 | Hardeman County Community Health Center | Clinic/Center | 445 Nuckolls Rd, Bolivar, TN 38008-1539 | 2018-03-20 |
| 1366637969 | Hardeman County Community Health Center | Clinic/Center | 1132 Industrial Dr, Henderson, TN 38340-1310 | 2007-09-07 |
| 1356531610 | Hardeman County Community Health Center | Clinic/Center | 17 1st St E, Stanton, TN 38069-4426 | 2007-08-01 |
| 1558721233 | Hardeman County Community Health Center | Pharmacist | 629 Nuckolls Rd, Bolivar, TN 38008-1599 | 2016-02-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | HARDEMAN COUNTY COMMUNITY HEALTH CENTER | 629 Nuckolls Rd, Bolivar, TN 38008-1599 |
| Street Address |
629 NUCKOLLS RD |
| City | BOLIVAR |
| State | TN |
| Zip Code | 38008-1599 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982606497 | Richard Mast Reinhard IIi | Pediatrics | 629 Nuckolls Rd, Bolivar, TN 38008 | 2005-08-15 |
| 1578101499 | Merry Anna Snider | Nurse Practitioner | 629 Nuckolls Rd, Bolivar, TN 38008-1599 | 2019-12-11 |
| 1003381815 | Rebekah Kathleen Rossetta | Nurse Practitioner | 629 Nuckolls Rd, Bolivar, TN 38008-1599 | 2018-10-08 |
| 1851828677 | Deborah Dillard | Registered Nurse | 629 Nuckolls Rd, Bolivar, TN 38008-1599 | 2017-05-11 |
| 1336688043 | Eric Alan Folk | Pharmacist | 629 Nuckolls Rd, Bolivar, TN 38008-1599 | 2017-02-14 |
| 1366984239 | Rebecca Lillian Long | Nurse Practitioner | 629 Nuckolls Rd, Bolivar, TN 38008-1599 | 2016-11-09 |
| 1558721233 | Hardeman County Community Health Center | Pharmacist | 629 Nuckolls Rd, Bolivar, TN 38008-1599 | 2016-02-24 |
| 1871966499 | Hcchc Pharmacy | Pharmacy | 629 Nuckolls Rd, Suite A, Bolivar, TN 38008-1599 | 2015-11-04 |
| 1427296276 | Samuel Terry Johnson Jr. | Family Medicine | 629 Nuckolls Rd, Bolivar, TN 38008-1599 | 2009-02-02 |
| 1568508448 | Olufemi E Soyinka | Family Medicine | 629 Nuckolls Rd, Bolivar, TN 38008-1599 | 2007-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720639172 | Shanna Shackelford | Nurse Practitioner | 11100 Old Hwy 64 W, Bolivar, TN 38008 | 2019-09-26 |
| 1598326233 | Holly Brooke Shourd | Family Medicine | 1359 W Market St., Bolivar, TN 38008 | 2019-06-24 |
| 1992299234 | Angela Dawn Haynes | Registered Nurse | 10825 Hwy 64w, Bolivar, TN 38008 | 2018-06-20 |
| 1326595919 | Ashley Evon Jowers | Nurse Practitioner | 11100 Old Hwy 64 West, Bolivar, TN 38008 | 2016-09-01 |
| 1942458344 | Anita Pearl Johnson | Physical Therapy Assistant | 700 Knuckolls Ave, Bolivar, TN 38008 | 2008-08-28 |
| 1841340007 | State of Tennessee | Public Health or Welfare | 10825 Old Hwy 64, Bolivar, TN 38008 | 2007-01-11 |
| 1164479721 | Betty Ragon Lenoir | Physical Therapist | 789 Tennessee St, Bolivar, TN 38008 | 2006-05-28 |
| 1689623050 | County of Hardeman | Ambulance | 735 Naylor St, Bolivar, TN 38008 | 2006-05-10 |
| 1841287109 | Michiel Brent Rudder | Family Medicine | 622 West Market Street, Bolivar, TN 38008 | 2005-10-03 |
| 1700288024 | Elizabeth Gault Ligon | Optometrist | 725 W Market St, Bolivar, TN 38008 | 2014-09-17 |
| Find all providers in zip 38008 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164897161 | Ozarks Resource Group | Clinic/Center | 203 E. Broadway St., Bolivar, MO 65613 | 2015-12-02 |
| 1396074324 | Primary Health Network | Clinic/Center | 802 Mckinley Street, Bolivar, PA 15923-0038 | 2009-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912525809 | Christ Community Health Services, Inc | Clinic/Center | 4350 Chuck Ave, Memphis, TN 38118-4076 | 2020-07-08 |
| 1730707621 | Christ Community Health Services, Inc. | Clinic/Center | 3206 Poplar Ave, Memphis, TN 38111-3502 | 2020-07-08 |
| 1003442112 | Christ Commuity Health Services Inc | Clinic/Center | 3360 S 3rd St, Memphis, TN 38109-2944 | 2020-03-20 |
| 1689160939 | Maury Regional Hospital | Clinic/Center | 98 Experiment Station Lane, Columbia, TN 38401-4700 | 2018-07-10 |
| 1194245399 | United Neighborhood Health Services, Inc. | Clinic/Center | 442 Metroplex Dr Ste 200, Nashville, TN 37211-3112 | 2017-06-20 |
| 1659745354 | Memphis Health Center, Inc. | Clinic/Center | 4250 Faronia Rd Ste 2a, Memphis, TN 38116-6527 | 2015-11-18 |
| 1639546187 | United Neighborhood Health Services, Inc. | Clinic/Center | 3904 Gallatin Pike, Nashville, TN 37216 | 2015-08-31 |
| 1790170389 | Maury Regional Hospital | Clinic/Center | 854 W James M Campbell Blvd Ste 301, Columbia, TN 38401-4659 | 2015-04-01 |
| 1285999128 | United Neighborhood Health Services, Inc | Clinic/Center | 401 Walton Ln, Nashville, TN 37216-1018 | 2012-07-06 |
| 1891058848 | United Neighborhood Health Services, Inc | Clinic/Center | 1900 Hobson Pike, Antioch, TN 37013-2421 | 2012-06-23 |
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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.