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NPI 1609942309

NPI 1609942309 : NATIONAL ASSISTANCE BUREAU, INC. : TIPTONVILLE, TN

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General NPI Number Information
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    NPI Number           |    1609942309
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    Entity Type          |    Organization 
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    Legal Business Name  |    NATIONAL ASSISTANCE BUREAU, INC. 
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Dates
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    Enumeration Date     |    11/27/2006
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    Last Update Date     |    09/29/2008
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Provider Practice Location Address
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    Address Line         |    1034 REELFOOT ST 
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    City                 |    TIPTONVILLE
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    State                |    TN
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    Zip                  |    38079-1607
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    Country              |    US
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    Telephone            |    731-253-6681
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    Fax                  |    731-253-8014
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Provider Business Mailing Address
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    Address Line         |    1145 HEMBREE RD 
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    City                 |    ROSWELL
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    State                |    GA
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    Zip                  |    30076-1122
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    Country              |    US
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    Telephone            |    770-650-8773
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    Fax                  |    770-650-9732
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Authorized Official
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    Title or Position    |    MANAGER
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    Name                 |     TYGH A BROGDON 
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    Credential           |    
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    Telephone            |    770-650-8773
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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       |    0000000151
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    License Number State |    TN
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