Provider Demographics
NPI:1760280499
Name:DMS PRIMARY CARE
Entity type:Organization
Organization Name:DMS PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SELLERS-MOONEY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:865-622-0454
Mailing Address - Street 1:2336 COAL TIPPLE HOLW STE A
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:VA
Mailing Address - Zip Code:24266-5819
Mailing Address - Country:US
Mailing Address - Phone:865-622-0454
Mailing Address - Fax:
Practice Address - Street 1:2336 COAL TIPPLE HOLW STE A
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:VA
Practice Address - Zip Code:24266-5819
Practice Address - Country:US
Practice Address - Phone:865-622-0454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center