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NPI Code Detail

MEDICARE: NHC HEALTHCARE SOMERVILLE LLC

MEDICARE: NHC HEALTHCARE SOMERVILLE LLC
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
1261QR0400XRehabilitation Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14041447OTHERPPO

General Provider Information

NPI Number : 1679614143
Entity Type Code : Organization
Provider Name (Legal Business Name) : NHC HEALTHCARE SOMERVILLE LLC
Provider Business Mailing Address
First Line : 308 LAKE DR
Second Line :
City : SOMERVILLE
State : TN
Zip : 38068-9716
Country : US
Telephone Number : 901-465-9861
Fax Number :
Provider Business Practice Location Address
First Line : 308 LAKE DR
Second Line :
City : SOMERVILLE
State : TN
Zip : 38068-9716
Country : US
Telephone Number : 901-465-9861
Fax Number :
Authorized Official
Title or Position : SVP
Name : R MICHAEL USSERY
Credential :
Telephone Number : 615-890-2020
Provider Enumeration Date : 02/09/2007
Last Update Date : 08/22/2020

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Directions to “NHC HEALTHCARE SOMERVILLE LLC ” Practice Location

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