| Organization Name: | ROANE URGENT CARE CLINIC LLC |
| NPI Number: | 1396173423 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | COREY E PAYNE (OWNER) |
| Mailing Address: | 2497 S. Roane St Suite 110 B Harriman |
| State: | TN US |
| Postal Code: | 37748 |
| Phone Number: | 8652553310 |
| Fax Number: | 8655900196 |
| NPI Enumeration Date: | 10/29/2013 |
| NPI Last Update Date: | 02/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |