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General NPI Number Information
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NPI Number | 1861208704
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Entity Type | Organization
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Legal Business Name | THYME CARE KS PA
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 10 LEA AVE STE 760
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City | NASHVILLE
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State | TN
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Zip | 37210-3541
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Country | US
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Telephone | 201-526-8484
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Fax |
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Provider Business Mailing Address
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Address Line | 10 LEA AVE STE 760
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City | NASHVILLE
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State | TN
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Zip | 37210-3541
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT JEFFERY GREEN
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Credential | MD
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Telephone | 201-526-8484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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