Healthcare Provider Details

I. General information

NPI: 1205243003
Provider Name (Legal Business Name): EKANCA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2014
Last Update Date: 07/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 MARTIN RD
LIMESTONE TN
37681-4753
US

IV. Provider business mailing address

1905 MARTIN RD
LIMESTONE TN
37681-4753
US

V. Phone/Fax

Practice location:
  • Phone: 423-930-8081
  • Fax: 888-505-3861
Mailing address:
  • Phone: 423-930-8081
  • Fax: 888-505-3861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberL000000014363
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State

VIII. Authorized Official

Name: MR. ANTHONY JAMES AUSTIN
Title or Position: PRESIDENT
Credential:
Phone: 423-930-8081