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Organization
BORDEAUX LONG TERM CARE
Active
Organization
BORDEAUX LONG TERM CARE
Active
Other names
Bordeaux Long-Term Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON BOYD FACHE (INTERIM CEO)
(615) 341-4491
Entity
Organization
Contact information
Practice address
1414 COUNTY HOSPITAL RD, NASHVILLE, TN 37218-3023
(615) 862-7005
(615) 862-6960
Mailing address
1414 COUNTY HOSPITAL RD, NASHVILLE, TN 37218-3023
(615) 862-7005
(615) 862-6960
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
0000000063
TN
314000000X
Skilled Nursing Facility
0000000063
TN
314000000X
Skilled Nursing Facility
Primary
63
TN
332B00000X
Durable Medical Equipment & Medical Supplies
0175630001
TN
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
0175630001
TN
3336L0003X
Long Term Care Pharmacy
4646322
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0445033
—
TN
05
—
1454877
—
TN
01
—
4414330
PHARMACY
TN
05
—
7440149
—
TN
Enumeration date
09/15/2005
Last updated
06/03/2013
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