MEDICARE: BENCHMARK HEALTH SERVICES, LLC

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
1	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1245636323
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BENCHMARK HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	6397 LEE HWY STE 300
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-2564
Country	:	US
Telephone Number	:	423-238-8923
Fax Number	:	423-954-7399

Provider Business Practice Location Address
First Line	:	1525 CELANESE RD
Second Line	:	STE 113
City	:	ROCK HILL
State	:	SC
Zip	:	29732-1757
Country	:	US
Telephone Number	:	803-366-8243
Fax Number	:	803-366-8245

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	LISA BENETTO
Credential	:
Telephone Number	:	423-238-8923

Provider Enumeration Date	:	11/17/2014
Last Update Date	:	08/31/2017

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