1447341268 NPI number — THE NOWELL CORPORATION

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 1447341268 NPI number — THE NOWELL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE NOWELL 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:
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:
1447341268
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/11/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
721 HIGHWAY 321 N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LENOIR CITY
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37771-5003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
865-988-0000
Provider Business Mailing Address Fax Number:
865-986-1542

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1915 WHITE AVE
Provider Second Line Business Practice Location Address:
FLOOR 2
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37916-2300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-541-1452
Provider Business Practice Location Address Fax Number:
865-541-1453
Provider Enumeration Date:
09/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
THOMASON
Authorized Official First Name:
CHASTITY
Authorized Official Middle Name:
R
Authorized Official Title or Position:
MEDICAL BILLING/DME SUPERVISOR
Authorized Official Telephone Number:
865-988-0000

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4164496 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 702008365 . This is a "CARITEN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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