Healthcare Provider Details

I. General information

NPI: 1881613909
Provider Name (Legal Business Name): TAKOMA HOSPITAL & SANITARIUM TRAINING SCHOOL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 TAKOMA AVE
GREENEVILLE TN
37743-4647
US

IV. Provider business mailing address

401 TAKOMA AVE
GREENEVILLE TN
37743-4647
US

V. Phone/Fax

Practice location:
  • Phone: 423-639-3151
  • Fax: 423-636-2374
Mailing address:
  • Phone: 423-639-3151
  • Fax: 423-636-2374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number0000000054
License Number StateTN

VIII. Authorized Official

Name: BLIN RICHARDS
Title or Position: CFO
Credential:
Phone: 423-636-2376