1265847594 NPI number — CARIS HEALTHCARE, LP

Table of content: (NPI 1265847594)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265847594 NPI number — CARIS HEALTHCARE, LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARIS HEALTHCARE, LP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265847594
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/25/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10651 COWARD MILL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KNOXVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37931-3006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
865-694-4848
Provider Business Mailing Address Fax Number:
865-934-4291

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5450 PETERS CREEK RD
Provider Second Line Business Practice Location Address:
SUITE 111
Provider Business Practice Location Address City Name:
ROANOKE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24019-3894
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-561-0958
Provider Business Practice Location Address Fax Number:
540-561-0839
Provider Enumeration Date:
06/25/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SEIVERS
Authorized Official First Name:
HOYT
Authorized Official Middle Name:
ALAN
Authorized Official Title or Position:
VICE PRESIDENT OF FINANCE
Authorized Official Telephone Number:
865-694-4848

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)