Healthcare Provider Details

I. General information

NPI: 1821015256
Provider Name (Legal Business Name): CUNNINGHAM HOME MEDICAL EQUIPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N BROAD ST
NEW TAZEWELL TN
37825-6603
US

IV. Provider business mailing address

201 N BROAD ST PO BOX 67
NEW TAZEWELL TN
37825-6603
US

V. Phone/Fax

Practice location:
  • Phone: 423-626-3151
  • Fax: 423-626-7384
Mailing address:
  • Phone: 423-626-3151
  • Fax: 423-626-7384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number654
License Number StateTN

VIII. Authorized Official

Name: MR. FRANKIE J TOLLIVER
Title or Position: OWNER MANAGER
Credential:
Phone: 423-626-3151