MEDICARE: THAMES HEALTHCARE GROUP, 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
1	314000000X	Skilled Nursing Facility	100349	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982701413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THAMES HEALTHCARE GROUP, LLC

Provider Business Mailing Address
First Line	:	2323 CONCRETE RD
Second Line	:
City	:	CARLISLE
State	:	KY
Zip	:	40311-9721
Country	:	US
Telephone Number	:	859-289-3492
Fax Number	:	859-289-3493

Provider Business Practice Location Address
First Line	:	2323 CONCRETE RD
Second Line	:
City	:	CARLISLE
State	:	KY
Zip	:	40311-9721
Country	:	US
Telephone Number	:	859-289-3492
Fax Number	:	859-289-3493

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. KAREN G MCDANIEL
Credential	:
Telephone Number	:	252-523-9094

Provider Enumeration Date	:	09/19/2006
Last Update Date	:	07/14/2021

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