1871786798 NPI number — AMARA HOME CARE,INC.

Table of content: (NPI 1871786798)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871786798 NPI number — AMARA HOME CARE,INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMARA HOME CARE,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:
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:
1871786798
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/14/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 CHEROKEE BLVD
Provider Second Line Business Mailing Address:
SUITE 303
Provider Business Mailing Address City Name:
CHATTANOOGA
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37405-3878
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-756-2411
Provider Business Mailing Address Fax Number:
423-664-4277

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 CHEROKEE BLVD
Provider Second Line Business Practice Location Address:
SUITE 303
Provider Business Practice Location Address City Name:
CHATTANOOGA
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37405-3878
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-756-2411
Provider Business Practice Location Address Fax Number:
423-664-4277
Provider Enumeration Date:
08/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SPRIGGS
Authorized Official First Name:
DAN
Authorized Official Middle Name:
WENDELL
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
423-756-2411

Provider Taxonomy Codes

  • Taxonomy code: 385H00000X , with the licence number:  L4380571921 , 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: 5440127 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com