# BORDEAUX LONG TERM CARE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bordeaux Long-Term Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083609168
- **Authorized official:** MR. JASON BOYD FACHE (INTERIM CEO)
- **Authorized official phone:** (615) 341-4491

## Contact information

- **Practice address:** 1414 COUNTY HOSPITAL RD, NASHVILLE, TN 37218-3023
- **Practice address phone:** (615) 862-7005
- **Practice address fax:** (615) 862-6960
- **Mailing address:** 1414 COUNTY HOSPITAL RD, NASHVILLE, TN 37218-3023
- **Mailing address phone:** (615) 862-7005
- **Mailing address fax:** (615) 862-6960

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 0000000063 | TN | — |
| 314000000X | Skilled Nursing Facility | 0000000063 | TN | — |
| 314000000X | Skilled Nursing Facility | 63 | TN | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0175630001 | TN | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | 0175630001 | TN | — |
| 3336L0003X | Long Term Care Pharmacy | 4646322 | TN | — |

## Other

- **Enumeration date:** 09/15/2005
- **Last updated:** 06/03/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0445033 | — | TN |
| 05 | — | 1454877 | — | TN |
| 01 | — | 4414330 | PHARMACY | TN |
| 05 | — | 7440149 | — | TN |