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General NPI Number Information
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NPI Number | 1962435255
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Entity Type | Organization
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Legal Business Name | TAKOMA ADVENTIST HOSPITAL
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1021 COOLIDGE ST
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City | GREENEVILLE
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State | TN
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Zip | 37743-4672
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Country | US
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Telephone | 423-636-0700
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Fax | 423-636-0706
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Provider Business Mailing Address
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Address Line | 1021 COOLIDGE ST
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City | GREENEVILLE
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State | TN
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Zip | 37743-4672
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Country | US
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Telephone | 423-636-0700
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Fax | 423-636-0706
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Authorized Official
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Title or Position | CFO
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Name | BLIN RICHARDS
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Credential |
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Telephone | 423-639-3151
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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 | 00000000-86
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License Number State | TN
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