Provider Demographics
NPI:1932523388
Name:HEALTH HEROES OF TENNESSEE, INC.
Entity type:Organization
Organization Name:HEALTH HEROES OF TENNESSEE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LIBERTY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-220-2484
Mailing Address - Street 1:326 PRAIRIE STREET NORTH
Mailing Address - Street 2:
Mailing Address - City:UNION SPRINGS
Mailing Address - State:AL
Mailing Address - Zip Code:36089-1417
Mailing Address - Country:US
Mailing Address - Phone:205-609-0268
Mailing Address - Fax:866-737-9625
Practice Address - Street 1:233 BEDFORD WAY
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064
Practice Address - Country:US
Practice Address - Phone:205-609-0268
Practice Address - Fax:866-737-9625
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH HEROES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-05
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000040964208D00000X
TNMD000040964208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty