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General NPI Number Information
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NPI Number | 1508007048
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Entity Type | Organization
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Legal Business Name | HOME CARE MEDICAL MANAGEMENT
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Dates
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Enumeration Date | 03/12/2009
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Last Update Date | 06/23/2010
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Provider Practice Location Address
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Address Line | 609 REGENCY LN
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City | ELIZABETHTON
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State | TN
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Zip | 37643-3062
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Country | US
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Telephone | 423-543-5652
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Fax | 423-543-5651
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Provider Business Mailing Address
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Address Line | 609 REGENCY LN
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City | ELIZABETHTON
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State | TN
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Zip | 37643-3062
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Country | US
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Telephone | 423-543-5652
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Fax | 423-543-5651
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Authorized Official
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Title or Position | OWNER
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Name | SHARON MERRYMAN
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Credential | RN
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Telephone | 423-543-5652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | H445144
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License Number State | TN
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