Basic Information
| Provider Information | |||||||||
| NPI: | 1447596390 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEARTH HOSPICE OF TENNESSEE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 FAULCONER DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229035089 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4349779711 | ||||||||
| FaxNumber: | 4349779715 | ||||||||
| Practice Location | |||||||||
| Address1: | 513 GEORGIA AVE | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374033402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4235316555 | ||||||||
| FaxNumber: | 4235316565 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2012 | ||||||||
| LastUpdateDate: | 04/05/2021 | ||||||||
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| AuthorizedOfficialLastName: | HUNTER | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | BRADLEY | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT & CEO | ||||||||
| AuthorizedOfficialTelephone: | 4349779711 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 04/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251G00000X | 620 | TN | Y | Agencies | Hospice Care, Community Based |
No ID Information.