Organization
CENTERWELL CERTIFIED HEALTHCARE CORP.
Active
Other names
CenterWell Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN NICHOLS (AUTHORIZED SIGNATORY)
(423) 230-1000
Entity
Organization
Contact information
Practice address
2004 AMERICAN WAY, SUITE 121, KINGSPORT, TN 37660-5892
(423) 230-1000
Mailing address
6330 SPRINT PKWY STE 300, OVERLAND PARK, KS 66211-1157
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0094420
G2
—
05
—
0094420
—
TN
01
—
013100P
G2
—
05
—
044-7254TN
—
TN
01
—
112207
G2
—
01
—
113414024D
G2
—
01
—
34511
G2
—
01
—
44711
G2
—
01
—
447254
G2
—
05
—
447254
—
TN
01
—
564395
G2
—
01
—
60-20010
G2
—
01
—
60-20020
G2
—
01
—
ANC015
G2
—
01
—
GA0178
G2
—
05
—
Q033359
—
TN
05
—
TN0112
—
TN
Enumeration date
07/04/2006
Last updated
11/29/2023
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