Healthcare Provider Details

I. General information

NPI: 1326185307
Provider Name (Legal Business Name): TENNESSEE DEPARTMENT OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 02/08/2022
Certification Date: 02/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 COUNTY ROAD 554
ATHENS TN
37303-6420
US

IV. Provider business mailing address

PO BOX 665
ATHENS TN
37371-0665
US

V. Phone/Fax

Practice location:
  • Phone: 423-745-7431
  • Fax: 423-744-7604
Mailing address:
  • Phone: 423-745-7431
  • Fax: 423-744-1604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD W MCCARTHY
Title or Position: ACCOUNTANT 3
Credential:
Phone: 423-634-5832