Healthcare Provider Details

I. General information

NPI: 1932523388
Provider Name (Legal Business Name): HEALTH HEROES OF TENNESSEE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2014
Last Update Date: 06/21/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 BEDFORD WAY
FRANKLIN TN
37064
US

IV. Provider business mailing address

326 PRAIRIE STREET NORTH
UNION SPRINGS AL
36089-1417
US

V. Phone/Fax

Practice location:
  • Phone: 205-609-0268
  • Fax: 866-737-9625
Mailing address:
  • Phone: 205-609-0268
  • Fax: 866-737-9625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD0000040964
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD000040964
License Number StateTN

VIII. Authorized Official

Name: MS. LIBERTY DUKE
Title or Position: PRESIDENT
Credential:
Phone: 334-220-2484