Healthcare Provider Details

I. General information

NPI: 1225033061
Provider Name (Legal Business Name): HOME HEALTHCARE LABORATORY OF AMERICA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 PREMIER CT STE 220
FRANKLIN TN
37067-8252
US

IV. Provider business mailing address

320 PREMIER CT STE 220
FRANKLIN TN
37067-8252
US

V. Phone/Fax

Practice location:
  • Phone: 615-771-0300
  • Fax: 615-771-0319
Mailing address:
  • Phone: 615-771-0300
  • Fax: 615-771-0319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number0000003334
License Number StateTN

VIII. Authorized Official

Name: MR. ROBERT S FLAK
Title or Position: REIMBURSEMENT DIRECTOR
Credential:
Phone: 615-771-0300