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General NPI Number Information
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NPI Number | 1154406759
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Entity Type | Organization
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Legal Business Name | BAPTIST MEMORIAL HOMECARE-UNION CITY
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 09/30/2020
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Provider Practice Location Address
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Address Line | 1201 BISHOP ST
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City | UNION CITY
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State | TN
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Zip | 38261-5403
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Country | US
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Telephone | 731-884-8617
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 621
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City | UNION CITY
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State | TN
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Zip | 38281-0621
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Country | US
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Telephone | 731-884-8617
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Fax |
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Authorized Official
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Title or Position | SR VP/ CLO
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Name | GREGORY M DUCKETT
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Credential |
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Telephone | 901-227-5233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 0000000188
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License Number State | TN
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