1356504153 NPI number — TENNESSE 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 1356504153 NPI number — TENNESSE DEPARTMENT OF HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TENNESSE 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:
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:
1356504153
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 TH FLOOR ANDREW JOHNSON TOWER
Provider Second Line Business Mailing Address:
710 JAMES ROBERTSON PARKWAY
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37247-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-532-7121
Provider Business Mailing Address Fax Number:
615-253-1998

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 TH FLOOR ANDREW JOHNSON TOWER
Provider Second Line Business Practice Location Address:
710 JAMES ROBERTSON PARKWAY
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37247-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-532-7121
Provider Business Practice Location Address Fax Number:
615-253-1998
Provider Enumeration Date:
07/02/2008

Additional Information

Authorized Official

Authorized Official Last Name:
OLIVER
Authorized Official First Name:
VALERIE
Authorized Official Middle Name:
D
Authorized Official Title or Position:
FISCAL DIRECTOR
Authorized Official Telephone Number:
615-532-7121

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)





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