Healthcare Provider Details

I. General information

NPI: 1104532431
Provider Name (Legal Business Name): CIRCLE H. HEALTHCARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2023
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 S MAIN ST
SWEETWATER TN
37874-2705
US

IV. Provider business mailing address

510 S MAIN ST
SWEETWATER TN
37874-2705
US

V. Phone/Fax

Practice location:
  • Phone: 423-337-7933
  • Fax: 423-337-2806
Mailing address:
  • Phone: 423-337-7933
  • Fax: 423-337-2806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. BRENT ERIC HICKEY
Title or Position: PRESIDENT/PIC
Credential: PHARMD
Phone: 423-210-0695