Basic Information
Provider Information | |||||||||
NPI: | 1265488704 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | UNITY HOSPICE CARE OF TENNESSEE, LLC | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1125 SCHILLING BLVD E STE 101 | ||||||||
Address2: |   | ||||||||
City: | COLLIERVILLE | ||||||||
State: | TN | ||||||||
PostalCode: | 380177078 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9017567322 | ||||||||
FaxNumber: | 9017567085 | ||||||||
Practice Location | |||||||||
Address1: | 202 E SCHOOL ST | ||||||||
Address2: |   | ||||||||
City: | LINDEN | ||||||||
State: | TN | ||||||||
PostalCode: | 370963371 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9315892010 | ||||||||
FaxNumber: | 9315892060 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/26/2006 | ||||||||
LastUpdateDate: | 01/22/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | PERKINS | ||||||||
AuthorizedOfficialFirstName: | KRISTAN | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: | COO | ||||||||
AuthorizedOfficialTelephone: | 9017567322 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 01/22/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251G00000X |   |   | Y |   | Agencies | Hospice Care, Community Based |   |
No ID Information.