Healthcare Provider Details

I. General information

NPI: 1760493878
Provider Name (Legal Business Name): THERACARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 N CENTRAL AVE
CENTERVILLE TN
37033-1421
US

IV. Provider business mailing address

110 W END AVE
CENTERVILLE TN
37033-1323
US

V. Phone/Fax

Practice location:
  • Phone: 931-729-4441
  • Fax:
Mailing address:
  • Phone: 931-729-4441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. CARLA F HINSON
Title or Position: OWNER
Credential:
Phone: 972-944-4131