Organization
VISTACARE HEALTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL THOMAS WEBB (PRESIDENT/CEO)
(901) 373-8831
Entity
Organization
Contact information
Practice address
8813 CHAFFEE RD, BRUNSWICK, TN 38014-0000
(901) 373-8831
(901) 373-7655
Mailing address
PO BOX 277, BRUNSWICK, TN 38014-0277
(901) 373-8831
(901) 373-7655
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0000000612
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000612
DME LICENSE
TN
05
—
1452522
—
TN
01
—
3144888
BLUE CROSS BLUE SHIELD
TN
Enumeration date
05/27/2005
Last updated
08/22/2020
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