MEDICARE: NORTHCREST HOME HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	0000000203	TN

General Provider Information

NPI Number	:	1225119860
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHCREST HOME HEALTH

Provider Business Mailing Address
First Line	:	3251 TOM AUSTIN HWY
Second Line	:
City	:	SPRINGFIELD
State	:	TN
Zip	:	37172-4525
Country	:	US
Telephone Number	:	615-382-3830
Fax Number	:	615-384-5102

Provider Business Practice Location Address
First Line	:	3251 TOM AUSTIN HWY
Second Line	:
City	:	SPRINGFIELD
State	:	TN
Zip	:	37172-4525
Country	:	US
Telephone Number	:	615-382-3830
Fax Number	:	615-384-5102

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MR. SCOTT RAYNES
Credential	:
Telephone Number	:	615-384-2411

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	08/22/2020

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Directions to “NORTHCREST HOME HEALTH ” Practice Location

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