State of Tennesseee
Organization Active NPI Public Health or Welfare Agency · Decaturville, TN
NPI 1184774341 · NPPES record last updated Aug 25, 2010
Key facts
- NPI
- 1184774341
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- Legal business name
- STATE OF TENNESSEEE
- Practice address
- 155 North Pleasant Street
Decaturville, TN 38329 - Phone
- (731) 852-2461
- Fax
- (731) 852-3794
- NPI assigned
- Jan 11, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Marilyn Barnes
- Title
- Regional Director
- Phone
- (731) 421-6700
Corporate family (same tax ID) 24
Practitioners 2
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
400 Carl Perkins Pkwy
Tiptonville, TN 38079
Phone (731) 253-9954
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | Yes |
Addresses
Primary practice location
155 North Pleasant Street
Decaturville, TN 38329
Mailing address
PO Box 178
155 North Pleasant Street
Decaturville, TN 38329
Phone (731) 852-2461
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4448122 | Medicaid | TN |
Other names
- Decatur County Health Department
Other providers in Decaturville, TN
- Lauren Everett Savell
- Holly Scott
- Tammy R Scott
- Chelsey Johnson Sparks
- Jacqueline Diane Staggs
- Debra Taylor
- Amber Diane Walker
- Westwood Health Care and Rehabilitation Center LLC
- Brian White
- Susan A White
All providers in Decaturville, 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 Aug 25, 2010. 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.