MEDICARE: CLINCH RIVER HOME HEALTH, INC

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	251E00000X	Home Health Agency	0000000001	TN

General Provider Information

NPI Number	:	1437151263
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINCH RIVER HOME HEALTH, INC

Provider Business Mailing Address
First Line	:	PO BOX 56
Second Line	:
City	:	CLINTON
State	:	TN
Zip	:	37717-0056
Country	:	US
Telephone Number	:	865-457-4263
Fax Number	:	865-457-9415

Provider Business Practice Location Address
First Line	:	401 SULPHUR SPRINGS RD
Second Line	:
City	:	CLINTON
State	:	TN
Zip	:	37716-2222
Country	:	US
Telephone Number	:	865-457-4263
Fax Number	:	865-457-9415

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. ELIZABETH A FEE
Credential	:	RN
Telephone Number	:	865-457-4263

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	08/22/2020

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