Provider Demographics
NPI:1285617605
Name:HOME HEALTH CARE OF EAST TENNESSEE, INC.
Entity type:Organization
Organization Name:HOME HEALTH CARE OF EAST TENNESSEE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:PEMBERTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-630-7425
Mailing Address - Street 1:770 STUART RD NE STE 2
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-5081
Mailing Address - Country:US
Mailing Address - Phone:423-479-6892
Mailing Address - Fax:
Practice Address - Street 1:770 STUART RD NE STE 2
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-5081
Practice Address - Country:US
Practice Address - Phone:423-479-6892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-21
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNA3731100OtherJOHN DEERE
TN150695OtherBCBS PROVIDER #
TNA3731100OtherJOHN DEERE
TN44Q7279001Medicare ID - Type UnspecifiedCHATTANOOGA BRANCH ID #
TN44Q7279002Medicare ID - Type UnspecifiedSWEETWATER BRANCH ID #
TNA3731100OtherJOHN DEERE
TN44Q7279008Medicare ID - Type UnspecifiedTELLICO PLAINS BRANCH ID#
TN44Q7279002Medicare ID - Type UnspecifiedSWEETWATER BRANCH ID #
TN44Q7279008Medicare ID - Type UnspecifiedTELLICO PLAINS BRANCH ID#