Basic Information
| Provider Information | |||||||||
| NPI: | 1649363979 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NATIONAL HEALTHCARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4407 BARBARA DR | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379184403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8656034542 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2120 HIGHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379161112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8655254131 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/30/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | EDENFIELD | ||||||||
| AuthorizedOfficialFirstName: | TONI | ||||||||
| AuthorizedOfficialMiddleName: | RENEE | ||||||||
| AuthorizedOfficialTitleorPosition: | COTA/L | ||||||||
| AuthorizedOfficialTelephone: | 8656034542 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 0162 | TN | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.