Healthcare Provider Details

I. General information

NPI: 1558408500
Provider Name (Legal Business Name): TENNESEE 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

201 DOOLEY ST SE
CLEVELAND TN
37311-6220
US

IV. Provider business mailing address

201 DOOLEY ST SE
CLEVELAND TN
37311-6220
US

V. Phone/Fax

Practice location:
  • Phone: 423-728-7020
  • Fax: 423-479-6130
Mailing address:
  • Phone: 423-728-7020
  • Fax: 423-479-6130

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: ACCOUNTING MANAGER
Credential:
Phone: 423-634-5832