MEDICARE: ALEXIAN BROTHERS COMMUNITY SERVICES

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1871825950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEXIAN BROTHERS COMMUNITY SERVICES

Provider Business Mailing Address
First Line	:	1000 NEWBY ST
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37402-2703
Country	:	US
Telephone Number	:	423-634-0814
Fax Number	:	423-634-2049

Provider Business Practice Location Address
First Line	:	1000 NEWBY ST
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37402-2703
Country	:	US
Telephone Number	:	423-634-0814
Fax Number	:	423-634-2049

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. KEVIN MULHEARN
Credential	:
Telephone Number	:	423-886-0545

Provider Enumeration Date	:	02/01/2010
Last Update Date	:	02/01/2010

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Directions to “ALEXIAN BROTHERS COMMUNITY SERVICES ” Practice Location

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