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Contact Information

MCKENZIE MEDICAL CENTER LAB
205 HOSPITAL DR
SUITE A
MCKENZIE, TN38201-1649
 Phone: 731-352-7907
 Fax: 731-352-4459
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Clinical Medical Laboratory

291U00000X 69 Clinical Laboratory
 

Rural Health

261QR1300X B4[14] Rural Health Clinic
Indicates primary specialty

NPI Profile & details for MCKENZIE MEDICAL CENTER LAB

NPI # 1477747293
LBN Legal business name MCKENZIE MEDICAL CENTER LAB
Authorized official LISA PAGE - (CREDENTIALING MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/05/2007
Last updated 08/27/2019 - About 7 years ago
Identifiers
TN License # MD23833
TN Medicaid 3380640
Other 44D0315280 CLIA
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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