Provider Demographics
NPI:1396483657
Name:TUCKER-WALLS GROUP LLC
Entity type:Organization
Organization Name:TUCKER-WALLS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIKIA
Authorized Official - Middle Name:SIMONE
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:CNRP
Authorized Official - Phone:412-770-8732
Mailing Address - Street 1:314 SUNNYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-1841
Mailing Address - Country:US
Mailing Address - Phone:412-770-8732
Mailing Address - Fax:412-242-4540
Practice Address - Street 1:314 SUNNYLAND AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15227-1841
Practice Address - Country:US
Practice Address - Phone:412-770-8732
Practice Address - Fax:412-242-4540
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUCKER-WALLS GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health