Healthcare Provider Details

I. General information

NPI: 1699756015
Provider Name (Legal Business Name): KNOXVILLE HMA HOMECARE DME & HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2005
Last Update Date: 01/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7447 ANDERSONVILLE PIKE
KNOXVILLE TN
37938-4238
US

IV. Provider business mailing address

7447 ANDERSONVILLE PIKE
KNOXVILLE TN
37938-4238
US

V. Phone/Fax

Practice location:
  • Phone: 865-545-7951
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number0000000385
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number0000000385
License Number StateTN

VIII. Authorized Official

Name: LAURIE J HOLTSFORD
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 615-465-7466