Healthcare Provider Details

I. General information

NPI: 1265571194
Provider Name (Legal Business Name): FELLOWSHIP ASSOC. OF RESOURCE MINISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2941 DOUGLAS DAM RD
KODAK TN
37764-2027
US

IV. Provider business mailing address

PO BOX 74
KODAK TN
37764-0074
US

V. Phone/Fax

Practice location:
  • Phone: 865-933-8752
  • Fax: 865-933-4230
Mailing address:
  • Phone: 865-933-8752
  • Fax: 865-933-4230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. JIM BEELER
Title or Position: PRESIDENT
Credential:
Phone: 865-933-8752