Healthcare Provider Details

I. General information

NPI: 1447295548
Provider Name (Legal Business Name): THAMES HEALTHCARE GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 07/14/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2607 MAIN ST
BENTON KY
42025-7601
US

IV. Provider business mailing address

PO BOX 385
BENTON KY
42025-0385
US

V. Phone/Fax

Practice location:
  • Phone: 270-527-3296
  • Fax: 270-527-9349
Mailing address:
  • Phone: 270-527-3296
  • Fax: 270-527-9349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number10514
License Number StateKY

VIII. Authorized Official

Name: MS. KAREN G MCDANIEL
Title or Position: PRESIDENT
Credential:
Phone: 252-523-9094