Healthcare Provider Details

I. General information

NPI: 1740216225
Provider Name (Legal Business Name): THAMES HEALTHCARE GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 07/14/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5079 SCOTTSVILLE RD
BOWLING GREEN KY
42104-7897
US

IV. Provider business mailing address

PO BOX 51547
BOWLING GREEN KY
42102-5847
US

V. Phone/Fax

Practice location:
  • Phone: 270-782-1125
  • Fax: 270-782-6952
Mailing address:
  • Phone: 270-782-1125
  • Fax: 270-782-6952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number100498
License Number StateKY

VIII. Authorized Official

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