Healthcare Provider Details

I. General information

NPI: 1457317646
Provider Name (Legal Business Name): EL & DEE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1328 S JOHN B DENNIS HWY SUITE 207
KINGSPORT TN
37660-5494
US

IV. Provider business mailing address

1328 S JOHN B DENNIS HWY SUITE 207
KINGSPORT TN
37660-5494
US

V. Phone/Fax

Practice location:
  • Phone: 423-246-0100
  • Fax: 423-246-0300
Mailing address:
  • Phone: 423-246-0100
  • Fax: 423-246-0300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberL4381251167
License Number StateTN

VIII. Authorized Official

Name: M.D. MCCUE
Title or Position: OWNER
Credential:
Phone: 423-246-0100