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NPI Code Detail

MEDICARE: AIDESIDE HOME HEALTHCARE

MEDICARE: AIDESIDE HOME HEALTHCARE
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
1253Z00000XIn Home Supportive Care Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11851859441OTHERTNSUPPORTIVE SERVICES

General Provider Information

NPI Number : 1851859441
Entity Type Code : Organization
Provider Name (Legal Business Name) : AIDESIDE HOME HEALTHCARE
Provider Business Mailing Address
First Line : 705 GATE LN STE 202
Second Line :
City : KNOXVILLE
State : TN
Zip : 37909-3521
Country : US
Telephone Number : 865-419-0047
Fax Number : 865-315-7021
Provider Business Practice Location Address
First Line : 705 GATE LN STE 202
Second Line :
City : KNOXVILLE
State : TN
Zip : 37909-3521
Country : US
Telephone Number : 865-294-0059
Fax Number : 865-315-7021
Authorized Official
Title or Position : CEO
Name : MR. KEELIN JAFARI BROWN
Credential :
Telephone Number : 865-419-0047
Provider Enumeration Date : 03/04/2019
Last Update Date : 03/16/2019

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Directions to “AIDESIDE HOME HEALTHCARE ” Practice Location

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