Healthcare Provider Details

I. General information

NPI: 1336123538
Provider Name (Legal Business Name): BUCKEYE HOME HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 05/10/2021
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 W CENTRAL AVE
JAMESTOWN TN
38556-3405
US

IV. Provider business mailing address

PO BOX 1197
JAMESTOWN TN
38556-1197
US

V. Phone/Fax

Practice location:
  • Phone: 931-879-9926
  • Fax: 931-879-2353
Mailing address:
  • Phone: 931-879-9926
  • Fax: 931-879-2353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number508
License Number StateTN

VIII. Authorized Official

Name: MRS. PAULA J ALLRED
Title or Position: VICE PRESIDENT
Credential: DPH
Phone: 931-879-9926