Organization
ARDMORE HEALTHCARE, LLC
Active
Other names
Ardmore Health and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS D JOHNSON (CHIEF MANAGER)
(423) 478-5953
Entity
Organization
Contact information
Practice address
25385 MAIN ST, ARDMORE, TN 38449-3155
(931) 427-2143
Mailing address
25385 MAIN ST, ARDMORE, TN 38449-3155
(931) 427-2143
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0445321
—
TN
05
—
7740277
—
TN
Enumeration date
09/19/2013
Last updated
03/28/2019
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