Healthcare Provider Details

I. General information

NPI: 1689831802
Provider Name (Legal Business Name): HARROGATE FAMILY & HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 02/12/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 WESTMORELAND ST LOWR LEVEL
HARROGATE TN
37752-8253
US

IV. Provider business mailing address

169 WESTMORELAND ST LOWR LEVEL
HARROGATE TN
37752-8253
US

V. Phone/Fax

Practice location:
  • Phone: 423-869-0004
  • Fax: 423-869-5555
Mailing address:
  • Phone: 423-869-0004
  • Fax: 423-869-5555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DEBBIE A POORE
Title or Position: OWNER
Credential: FNP
Phone: 423-869-0004