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General NPI Number Information
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NPI Number | 1154450344
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Entity Type | Organization
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Legal Business Name | TAKOMA REGIONAL HOSPITAL
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 401 TAKOMA AVE
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City | GREENEVILLE
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State | TN
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Zip | 37743-4647
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Country | US
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Telephone | 828-687-5281
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Fax | 828-687-5298
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Provider Business Mailing Address
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Address Line | PO BOX 11407
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City | BIRMINGHAM
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State | AL
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Zip | 35246-1412
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Country | US
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Telephone | 828-687-5281
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Fax | 828-687-5298
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. BLIN RICHARDS
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Credential |
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Telephone | 423-636-0369
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 98
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License Number State | TN
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