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General NPI Number Information
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NPI Number | 1578079067
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Entity Type | Organization
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Legal Business Name | RAYZER SHARP ENTERPRISES INC.
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Dates
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Enumeration Date | 12/19/2017
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Last Update Date | 12/19/2017
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Provider Practice Location Address
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Address Line | 802 LOVELL RD
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City | KNOXVILLE
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State | TN
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Zip | 37932-3264
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Country | US
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Telephone | 865-269-4483
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Fax | 865-288-7974
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Provider Business Mailing Address
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Address Line | 802 LOVELL RD
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City | KNOXVILLE
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State | TN
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Zip | 37932-3264
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Country | US
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Telephone | 865-269-4483
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Fax | 865-288-7974
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Authorized Official
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Title or Position | OWNER
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Name | RAYMOND BALES
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Credential |
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Telephone | 865-269-4483
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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 | L000000020884
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License Number State | TN
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