Healthcare Provider Details

I. General information

NPI: 1053757419
Provider Name (Legal Business Name): NHC HEALTHCARE-TULLAHOMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2013
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 CEDAR LN
TULLAHOMA TN
37388-2227
US

IV. Provider business mailing address

1321 CEDAR LN
TULLAHOMA TN
37388-2227
US

V. Phone/Fax

Practice location:
  • Phone: 931-222-4207
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: GREGORY BIDWELL
Title or Position: MANAGER OF LLC
Credential:
Phone: 615-893-2602