Provider Demographics
NPI:1003867458
Name:TNMO HEALTHCARE, LLC
Entity Type:Organization
Organization Name:TNMO HEALTHCARE, LLC
Other - Org Name:AVALON HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF LICENSURE
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-814-2013
Mailing Address - Street 1:655 BRAWLEY SCHOOL RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9125
Mailing Address - Country:US
Mailing Address - Phone:704-664-2876
Mailing Address - Fax:
Practice Address - Street 1:7315 LEE HWY STE 131
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1560
Practice Address - Country:US
Practice Address - Phone:423-892-3737
Practice Address - Fax:423-892-3877
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REGENCY HEALTHCARE GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000368251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0441576Medicaid
TN441576Medicare Oscar/Certification