State of Tennessee
Organization Active NPI Public Health or Welfare Agency · Pulaski, TN
NPI 1124048996 · NPPES record last updated Sep 25, 2012
Key facts
- NPI
- 1124048996
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- Legal business name
- STATE OF TENNESSEE
- Practice address
- 209 S Cedar LN
Pulaski, TN 38478-3502 - Phone
- (931) 363-5506
- Fax
- (931) 424-7020
- NPI assigned
- Jul 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Barbara J Whitwell
- Title
- Office Supervisor
- Phone
- (930) 490-8334
Corporate family (same tax ID) 24
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041013001259 | TN | Part B Supplier - Mass Immunization (Roster Biller Only) | 5698687077 | This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Trousdale County Health
Locations
209 S Cedar Ln
Pulaski, TN 38478
Phone (931) 363-5506
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | Yes |
Addresses
Primary practice location
209 S Cedar LN
Pulaski, TN 38478-3502
Mailing address
209 S Cedar LN
Pulaski, TN 38478-3502
Phone (931) 363-5506
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2007838 | Other | TN | BC/BS & TENNCARE SELECT |
| 4448007 | Medicaid | TN | |
| 3068448 | Other | TN | TENNCARE SELECT PCP |
Other names
- Giles County Health Department
Other providers in Pulaski, TN
- Loretta Smith
- Rory Clifford Smith
- Southeast Surgical, PLLC
- Southern Family Markets LLC
- Southern Tennessee Orthopaedic & Hand Surgery, PLLC
- Jessica Strong
- Richard F Stults
- Karen Suddarth
- Sutton Family Pharmacy, LLC.
- Julius Kelby Sutton
All providers in Pulaski, TN · Public Health or Welfare Agency in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.