Provider Demographics
NPI:1962927616
Name:EAGLE ACQUISITION VIII LLC
Entity type:Organization
Organization Name:EAGLE ACQUISITION VIII LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BENT
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILIPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-983-0261
Mailing Address - Street 1:PO BOX 5477
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37802-5477
Mailing Address - Country:US
Mailing Address - Phone:865-983-0261
Mailing Address - Fax:865-984-5108
Practice Address - Street 1:307 N 5TH ST
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37804-2921
Practice Address - Country:US
Practice Address - Phone:865-983-0261
Practice Address - Fax:865-984-5108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility