Organization
THOMAS O HENLEY
Active
Other names
Henley Medical
Organization subpart
No
Provider details
NPI number
Authorized official
AVE M HENLEY (CFO)
(423) 698-4200
Entity
Organization
Contact information
Practice address
1090 MCCALLIE AVENUE, CHATTANOOGA, TN 37404
(423) 698-4200
(423) 629-8810
Mailing address
1090 MCCALLIE AVENUE, CHATTANOOGA, TN 37404
(423) 698-4200
(423) 629-8810
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0000000482
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00528316A
—
GA
01
—
0082678
TENNCARE BLUECARE
TN
Enumeration date
10/12/2006
Last updated
05/17/2023
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