State of Tennessee

NPI #1942352554 in Spencer, Tennessee

Provider Information

NPI Number: 1942352554
Entity Type: Organization
Organization Name: State of Tennessee
Primary Specialty: Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date: Jan 17, 2007
Last Updated: Jan 7, 2025

Practice Location

Address: 907 OLD MCMINNVILLE ST
City: Spencer
State: Tennessee
ZIP Code: 38585-3200
Phone: (931) 946-2438

Authorized Official

Name: TAMMY STEWART
Title: CFO
Phone: (931) 520-4203

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Public Health or Welfare	251K00000X
Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC)	261QF0400X	Primary

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