Healthcare Provider Details
I. General information
NPI: 1700051851
Provider Name (Legal Business Name): BAPTIST INFUSION THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/29/2008
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3218 MORRIS AVE SUITE C
KNOXVILLE TN
37909-1527
US
IV. Provider business mailing address
3218 MORRIS AVE SUITE C
KNOXVILLE TN
37909-1527
US
V. Phone/Fax
- Phone: 865-525-4886
- Fax: 865-525-5995
- Phone: 865-525-4886
- Fax: 865-525-5995
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 3190 |
| License Number State | TN |
VIII. Authorized Official
Name: MR.
RONALD
NOLAND
SHERRILL
Title or Position: PRESIDENT
Credential: DPH,MPH
Phone: 865-525-4886