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NPI Code Detail

MEDICARE: MANAGEMENT CARE CORPORATION

MEDICARE: MANAGEMENT CARE CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility0000000340TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245216910
Entity Type Code : Organization
Provider Name (Legal Business Name) : MANAGEMENT CARE CORPORATION
Provider Business Mailing Address
First Line : 115 WOODLAWN DR
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-5978
Country : US
Telephone Number : 423-975-0095
Fax Number : 423-928-0358
Provider Business Practice Location Address
First Line : 115 WOODLAWN DR
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-5978
Country : US
Telephone Number : 423-975-0095
Fax Number : 423-928-0358
Authorized Official
Title or Position : PRESIDENT
Name : JIMMY R LEWIS
Credential :
Telephone Number : 423-975-5455
Provider Enumeration Date : 12/15/2005
Last Update Date : 08/22/2020

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Directions to “MANAGEMENT CARE CORPORATION ” Practice Location

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