Healthcare Provider Details
I. General information
NPI: 1245277110
Provider Name (Legal Business Name): NHC HEALTHCARE-SMITHVILLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/01/2006
Last Update Date: 03/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
825 FISHER AVE
SMITHVILLE TN
37166-2140
US
IV. Provider business mailing address
825 FISHER AVE
SMITHVILLE TN
37166-2140
US
V. Phone/Fax
- Phone: 615-597-4284
- Fax:
- Phone: 615-597-4284
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | 071 |
| License Number State | TN |
VIII. Authorized Official
Name:
GREGORY
G
BIDWELL
Title or Position: MANAGER OF LLC
Credential:
Phone: 615-893-2602