Provider Demographics
NPI:1114672946
Name:BUCKEYE HOME HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:BUCKEYE HOME HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALLRED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-879-9926
Mailing Address - Street 1:PO BOX 1197
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38556-1197
Mailing Address - Country:US
Mailing Address - Phone:931-397-7123
Mailing Address - Fax:
Practice Address - Street 1:136 FAIRBANKS RD
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-7077
Practice Address - Country:US
Practice Address - Phone:865-275-0100
Practice Address - Fax:865-298-5333
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BUCKEYE HOME HEALTH CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN508OtherSTATE LICENSE