1326185307 NPI number — TENNESSEE DEPARTMENT OF HEALTH

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 1326185307 NPI number — TENNESSEE DEPARTMENT OF HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TENNESSEE DEPARTMENT OF HEALTH
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:
1326185307
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/08/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 665
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATHENS
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37371-0665
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-745-7431
Provider Business Mailing Address Fax Number:
423-744-1604

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
393 COUNTY ROAD 554
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATHENS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37303-6420
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-745-7431
Provider Business Practice Location Address Fax Number:
423-744-7604
Provider Enumeration Date:
01/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MCCARTHY
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
W
Authorized Official Title or Position:
ACCOUNTANT 3
Authorized Official Telephone Number:
423-634-5832

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com