MEDICARE: SHALOM HOSPICE OF GREATER KNOXVILLE 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1689355620
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHALOM HOSPICE OF GREATER KNOXVILLE LLC

Provider Business Mailing Address
First Line	:	8351 E WALKER SPRINGS LN STE 402
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-3142
Country	:	US
Telephone Number	:
Fax Number	:	865-381-1204

Provider Business Practice Location Address
First Line	:	8351 E WALKER SPRINGS LN STE 402
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-3142
Country	:	US
Telephone Number	:	510-499-9977
Fax Number	:	865-381-1204

Authorized Official
Title or Position	:	CEO
Name	:	SAMUEL STERN
Credential	:
Telephone Number	:	510-499-9977

Provider Enumeration Date	:	07/31/2023
Last Update Date	:	06/09/2026

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