Provider Demographics
NPI:1366793838
Name:CLINCARE, INC.
Entity type:Organization
Organization Name:CLINCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MYRON
Authorized Official - Middle Name:B
Authorized Official - Last Name:TOWNS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-562-2439
Mailing Address - Street 1:PO BOX 331164
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-7510
Mailing Address - Country:US
Mailing Address - Phone:615-562-2439
Mailing Address - Fax:615-562-1144
Practice Address - Street 1:1718 CHURCH STREET
Practice Address - Street 2:BX 331164
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-7510
Practice Address - Country:US
Practice Address - Phone:615-562-2439
Practice Address - Fax:615-562-1144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN681217251V00000X, 251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3182613Medicaid
TN31826131Medicare PIN
C67818Medicare UPIN
TN3182613Medicaid