1942337183 NPI number — HOPE FAMILY HEALTH SERVICES

Table of content: (NPI 1942337183)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942337183 NPI number — HOPE FAMILY HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOPE FAMILY HEALTH SERVICES
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:
1942337183
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12124 HIGHWAY 52 W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTMORELAND
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37186-5063
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-644-2000
Provider Business Mailing Address Fax Number:
615-644-2078

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1124 NEW HIGHWAY 52 E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTMORELAND
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37186-5060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-644-2000
Provider Business Practice Location Address Fax Number:
615-644-2078
Provider Enumeration Date:
02/27/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DITTES
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
G
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
615-644-2000

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0400X , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 3728716 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".