1871539734 NPI number — CENTRE HOME CARE CORPORATION

Table of content: (NPI 1871539734)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871539734 NPI number — CENTRE HOME CARE CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRE HOME CARE CORPORATION
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:
CHEROKEE HOSPICE
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:
1871539734
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/20/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4000 MERIDIAN BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRANKLIN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37067-6325
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-465-7488
Provider Business Mailing Address Fax Number:
615-465-2986

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
775 CHEROKEE PLZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CENTRE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35960-1629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-927-1144
Provider Business Practice Location Address Fax Number:
256-927-8068
Provider Enumeration Date:
06/21/2006

Additional Information

			
		

Authorized Official

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

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 011 592 . This is a "BLUE CROSS/ BLUE SHIELD" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: PIC1542 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".