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General NPI Number Information
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NPI Number | 1821126475
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Entity Type | Organization
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Legal Business Name | TAKOMA REGIONAL HOSPITAL INC
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 1012 COOLIDGE ST
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City | GREENEVILLE
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State | TN
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Zip | 37743-4610
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Country | US
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Telephone | 828-687-5281
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Fax | 828-687-2598
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Provider Business Mailing Address
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Address Line | 1012 COOLIDGE ST
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City | GREENEVILLE
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State | TN
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Zip | 37743-4610
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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 EXECUTIVE OFFICER
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Name | MR. CARLYLE WALTON
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 86
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License Number State | TN
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