=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144963422
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NHC HEALTHCARE-HOLSTON HILLS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/15/2022
-----------------------------------------------------
Last Update Date | 04/15/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3916 BOYDS BRIDGE PIKE
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37914-6233
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-524-1500
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3916 BOYDS BRIDGE PIKE
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37914-6233
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER OF LLC
-----------------------------------------------------
Name | HOWARD J NASON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 865-523-2473
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR0400X
-----------------------------------------------------
Taxonomy Name | Rehabilitation Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------