1578501342 NPI number — FAMILY HOME CARE, INC

Table of content: (NPI 1578501342)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578501342 NPI number — FAMILY HOME CARE, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY HOME CARE, 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:
HOME CARE OF CHATTANOOGA
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:
1578501342
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/15/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7161 LEE HIGHWAY
Provider Second Line Business Mailing Address:
SUITE 500
Provider Business Mailing Address City Name:
CHATTANOOGA
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37421-9605
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-899-9166
Provider Business Mailing Address Fax Number:
423-899-9683

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7161 LEE HIGHWAY
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
CHATTANOOGA
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37421-8605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-899-9166
Provider Business Practice Location Address Fax Number:
423-899-9683
Provider Enumeration Date:
06/03/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HOLTSFORD
Authorized Official First Name:
LAURIE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR, BUSINESS OFFICE SUPPORT
Authorized Official Telephone Number:
615-465-7466

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  0000000107 , 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)