Healthcare Provider Details

I. General information

NPI: 1700847241
Provider Name (Legal Business Name): WOODS MEMORIAL HOME HEALTH AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 01/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

886 HIGHWAY 411 N
ETOWAH TN
37331-1912
US

IV. Provider business mailing address

886 HIGHWAY 411 N
ETOWAH TN
37331-1912
US

V. Phone/Fax

Practice location:
  • Phone: 423-263-3628
  • Fax: 423-263-3607
Mailing address:
  • Phone: 423-263-3628
  • Fax: 423-263-7573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number0000000168
License Number StateTN

VIII. Authorized Official

Name: MRS. NANCY D MORRIS
Title or Position: DIRECTOR
Credential:
Phone: 423-263-3600