Provider Demographics
NPI:1164758397
Name:CARIS HEALTHCARE, LP
Entity Type:Organization
Organization Name:CARIS HEALTHCARE, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:CUSICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-694-4848
Mailing Address - Street 1:10651 COWARD MILL RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931-3006
Mailing Address - Country:US
Mailing Address - Phone:865-694-4848
Mailing Address - Fax:865-694-7878
Practice Address - Street 1:2140 E ANDREW JOHNSON HWY
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-5808
Practice Address - Country:US
Practice Address - Phone:423-638-2226
Practice Address - Fax:423-638-2299
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARIS HEALTHCARE, LP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN610251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4217939OtherBCBS TN
TN0441587Medicaid
TN4217939OtherBCBS TN