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NPI Code Detail

MEDICARE: SUSAN REBECCA ADAMS HIS

MEDICARE: SUSAN REBECCA ADAMS HIS
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
1237700000XHearing Instrument Specialist1081TN
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1780870741
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN REBECCA ADAMS HIS
Provider Business Mailing Address
First Line : PO BOX 9054
Second Line :
City : GRAY
State : TN
Zip : 37615-9054
Country : US
Telephone Number : 423-467-3600
Fax Number : 423-467-3644
Provider Business Practice Location Address
First Line : 1500 W ELK AVE # 100A
Second Line :
City : ELIZABETHTON
State : TN
Zip : 37643-2654
Country : US
Telephone Number : 423-440-3433
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2007
Last Update Date : 07/08/2025

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