MEDICARE: PARAMOUNT HEALTHCARE

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	332B00000X	Durable Medical Equipment & Medical Supplies	000842475	TN

General Provider Information

NPI Number	:	1871085357
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARAMOUNT HEALTHCARE

Provider Business Mailing Address
First Line	:	7535 COLONY LAKE DR
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-1305
Country	:	US
Telephone Number	:	561-537-0370
Fax Number	:	865-292-2327

Provider Business Practice Location Address
First Line	:	6716 CENTRAL AVENUE PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37912-1425
Country	:	US
Telephone Number	:	865-292-2327
Fax Number	:	865-292-2327

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. IAN PATRICK CLARKE
Credential	:
Telephone Number	:	561-537-0370

Provider Enumeration Date	:	05/31/2018
Last Update Date	:	06/16/2018

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