1407845944 NPI number — HOME HEALTH CARE OF WEST TENNESSEE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407845944 NPI number — HOME HEALTH CARE OF WEST TENNESSEE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOME HEALTH CARE OF WEST TENNESSEE, 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:
Provider Other Organization Name Type Code:
6
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:
1407845944
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/11/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2995 APPLING RD STE 102
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BARTLETT
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38133-8963
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-266-5100
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2995 APPLING RD
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
BARTLETT
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38133-8963
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-266-5100
Provider Business Practice Location Address Fax Number:
901-266-5644
Provider Enumeration Date:
10/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
PEMBERTON
Authorized Official First Name:
MARGARET
Authorized Official Middle Name:
S
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
502-394-2321

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  227 , 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: 4060536 . This is a "BCBSTN PROVIDER NUMBER" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 44Q7564001 . This is a "MEDICARE BRANCH ID (ATOKA)" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 447564 . This is a "AETNA PROVIDER NUMBER" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 0447564 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 447564 . This is a "TRI CARE PROVIDER NUMBER" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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