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NPI Code Detail

MEDICARE: STATE OF TENNESSEE

MEDICARE: STATE OF TENNESSEE
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
1251K00000XPublic Health or Welfare Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10118870OTHERTNBC/BS & TENNCARE SELECT
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
33071777OTHERTNTENNCARE SELECT PCP

General Provider Information

NPI Number : 1528089265
Entity Type Code : Organization
Provider Name (Legal Business Name) : STATE OF TENNESSEE
Provider Business Mailing Address
First Line : 1909 HAMPSHIRE PIKE
Second Line :
City : COLUMBIA
State : TN
Zip : 38401-5650
Country : US
Telephone Number : 931-388-5757
Fax Number : 931-560-1129
Provider Business Practice Location Address
First Line : 1909 HAMPSHIRE PIKE
Second Line :
City : COLUMBIA
State : TN
Zip : 38401-5650
Country : US
Telephone Number : 931-388-5757
Fax Number : 931-560-1129
Authorized Official
Title or Position : OFFICE SUPERVISOR
Name : BARBARA J WHITWELL
Credential :
Telephone Number : 931-490-8334
Provider Enumeration Date : 07/21/2006
Last Update Date : 09/25/2012

Similar Medicare Providers

1114110285 — FRED H MELTON RN
Practice Location Address:
1909 HAMPSHIRE PIKE
COLUMBIA, TN
38401-5650
Practice Phone: 931-388-5757
Practice Fax:
1912188350 — MRS. JO VON THEOBALD RN
Practice Location Address:
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COLUMBIA, TN
38401-5650
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Practice Fax:
1043490477 — MS. JENNIFER WILKINSON HILL RN
Practice Location Address:
1909 HAMPSHIRE PIKE
COLUMBIA, TN
38401-5650
Practice Phone: 931-388-5757
Practice Fax:
1083895429 — MONICA LEIGH WELLS RN
Practice Location Address:
1909 HAMPSHIRE PIKE
COLUMBIA, TN
38401-5650
Practice Phone: 931-388-5757
Practice Fax:
1912188178 — KIMBERLY DAWN JOHNSON RN
Practice Location Address:
1909 HAMPSHIRE PIKE
COLUMBIA, TN
38401-5650
Practice Phone: 931-388-5757
Practice Fax:
1871767574 — ELIZABETH HOPE MCNABB
Practice Location Address:
1909 HAMPSHIRE PIKE
COLUMBIA, TN
38401-5650
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Practice Fax:

Directions to “STATE OF TENNESSEE ” Practice Location

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