1881613909 NPI number — TAKOMA HOSPITAL & SANITARIUM TRAINING SCHOOL, INC.

Table of content: (NPI 1881613909)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881613909 NPI number — TAKOMA HOSPITAL & SANITARIUM TRAINING SCHOOL, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TAKOMA HOSPITAL & SANITARIUM TRAINING SCHOOL, INC.
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:
TAKOMA ADVENTIST HOSPITAL
Provider Other Organization Name Type Code:
3
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:
1881613909
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 TAKOMA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENEVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37743-4647
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-639-3151
Provider Business Mailing Address Fax Number:
423-636-2374

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 TAKOMA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENEVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37743-4647
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-639-3151
Provider Business Practice Location Address Fax Number:
423-636-2374
Provider Enumeration Date:
07/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RICHARDS
Authorized Official First Name:
BLIN
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
423-636-2376

Provider Taxonomy Codes

  • Taxonomy code: 282NR1301X , with the licence number:  0000000054 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1000393 . This is a "TC TENNCARE SELECT" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 3278734 . This is a "MEDICARE PART B GROUP #" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: A3774401 . This is a "JOHN DEERE HEALTH PLAN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 1000393 . This is a "TC BLUE CARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: A3774301 . This is a "MEDICARE MANAGED CARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: A3774401 . This is a "TC JOHN DEERE MEDICAID" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 3924507 . This is a "MEDICARE LCSW GROUP" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 440050 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1000393 . This is a "BLUE CROSS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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