1649761511 NPI number — HONEYHILL HOMECARE, LLC

Table of content: GARDINE MICHELLE COLON GUERRA MD (NPI 1821254459)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649761511 NPI number — HONEYHILL HOMECARE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HONEYHILL HOMECARE, LLC
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:
1649761511
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
151 HERITAGE PARK DR STE 203
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MURFREESBORO
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37129-0505
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
629-201-6130
Provider Business Mailing Address Fax Number:
615-413-5190

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
151 HERITAGE PARK DR STE 203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MURFREESBORO
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37129-0505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
629-201-6130
Provider Business Practice Location Address Fax Number:
615-413-5190
Provider Enumeration Date:
05/25/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CUTTER
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
JAMES
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
615-971-9490

Provider Taxonomy Codes

  • Taxonomy code: 3747A0650X , with the licence number:  L000000021994 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3747P1801X , with the licence number: L000000021994 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 374U00000X , with the licence number: L000000021994 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 376J00000X , with the licence number: L000000021994 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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