Healthcare Provider Details

I. General information

NPI: 1689355620
Provider Name (Legal Business Name): SHALOM HOSPICE OF GREATER KNOXVILLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2023
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8351 E WALKER SPRINGS LN STE 402
KNOXVILLE TN
37923-3142
US

IV. Provider business mailing address

8351 E WALKER SPRINGS LN STE 402
KNOXVILLE TN
37923-3142
US

V. Phone/Fax

Practice location:
  • Phone: 510-499-9977
  • Fax: 865-381-1204
Mailing address:
  • Phone:
  • Fax: 865-381-1204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL STERN
Title or Position: CEO
Credential:
Phone: 510-499-9977