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Contact Information

CLEVELAND MEDICAL CLINIC INC
2305 CHAMBLISS AVE
CLEVELAND, TN37320
 Phone: 423-559-6000
 Fax: 423-559-6653
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hospitalist

208M00000X
 

Pain Medicine

208VP0000X 72 Physician/Pain Management
Indicates primary specialty

NPI Profile & details for CLEVELAND MEDICAL CLINIC INC

NPI # 1720149222
LBN Legal business name CLEVELAND MEDICAL CLINIC INC
Authorized official DEBBIE BREWER - (DIRECTOR)
Entity Organization
Organization subpart 1 Yes
Enumeration date 12/12/2006
Last updated 08/13/2008 - About 18 years ago
Identifiers
GA Medicaid 840698446A
TN Medicaid 3710153
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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