1770544637 NPI number — HOME COMFORT MEDICAL EQUIPMENT

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 1770544637 NPI number — HOME COMFORT MEDICAL EQUIPMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOME COMFORT MEDICAL EQUIPMENT
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:
1770544637
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/20/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
357 RIVERSIDE DRIVE
Provider Second Line Business Mailing Address:
SUITE 120
Provider Business Mailing Address City Name:
FRANKLIN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37064
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-790-1556
Provider Business Mailing Address Fax Number:
615-790-6841

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
277 UNDERPASS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ONEIDA
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37841
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-569-4663
Provider Business Practice Location Address Fax Number:
423-569-4668
Provider Enumeration Date:
03/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LANKFORD
Authorized Official First Name:
SHALIA
Authorized Official Middle Name:
ROBIN
Authorized Official Title or Position:
DIRECTOR OF A/R MANAGEMENT
Authorized Official Telephone Number:
615-790-1556

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1454466 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




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