1407845944 NPI number — HOME HEALTH CARE OF WEST TENNESSEE, INC.

Table of content: (NPI 1407845944)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407845944 NPI number — HOME HEALTH CARE OF WEST TENNESSEE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOME HEALTH CARE OF WEST TENNESSEE, INC.
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:
1407845944
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/11/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2995 APPLING RD STE 102
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BARTLETT
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38133-8963
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-266-5100
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2995 APPLING RD
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
BARTLETT
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38133-8963
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-266-5100
Provider Business Practice Location Address Fax Number:
901-266-5644
Provider Enumeration Date:
10/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
PEMBERTON
Authorized Official First Name:
MARGARET
Authorized Official Middle Name:
S
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
502-394-2321

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  227 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4060536 . This is a "BCBSTN PROVIDER NUMBER" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 44Q7564001 . This is a "MEDICARE BRANCH ID (ATOKA)" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 447564 . This is a "AETNA PROVIDER NUMBER" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 0447564 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 447564 . This is a "TRI CARE PROVIDER NUMBER" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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