Healthcare Provider Details
I. General information
NPI: 1245636323
Provider Name (Legal Business Name): BENCHMARK HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/17/2014
Last Update Date: 08/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1525 CELANESE RD STE 113
ROCK HILL SC
29732-1757
US
IV. Provider business mailing address
6397 LEE HWY STE 300
CHATTANOOGA TN
37421-2564
US
V. Phone/Fax
- Phone: 803-366-8243
- Fax: 803-366-8245
- Phone: 423-238-8923
- Fax: 423-954-7399
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LISA
BENETTO
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 423-238-8923