MEDICARE: CARESOUTH HHA HOLDINGS OF WINCHESTER 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	332B00000X	Durable Medical Equipment & Medical Supplies	647	TN

General Provider Information

NPI Number	:	1295824902
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARESOUTH HHA HOLDINGS OF WINCHESTER LLC

Provider Business Mailing Address
First Line	:	6688 N CENTRAL EXPRESSWAY
Second Line	:	SUITE 1300
City	:	DALLAS
State	:	TX
Zip	:	75206-3950
Country	:	US
Telephone Number	:	214-239-6500
Fax Number	:	214-239-6581

Provider Business Practice Location Address
First Line	:	207 HIGHWAY 41
Second Line	:
City	:	TRACY CITY
State	:	TN
Zip	:	37387
Country	:	US
Telephone Number	:	931-592-3454
Fax Number	:	931-592-3486

Authorized Official
Title or Position	:	CFO
Name	:	CHRIS WALKER
Credential	:
Telephone Number	:	214-239-6500

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	05/26/2021

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