Provider Demographics
NPI:1225033061
Name:HOME HEALTHCARE LABORATORY OF AMERICA INC
Entity Type:Organization
Organization Name:HOME HEALTHCARE LABORATORY OF AMERICA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REIMBURSEMENT DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:FLAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-771-0300
Mailing Address - Street 1:320 PREMIER CT
Mailing Address - Street 2:STE 220
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8252
Mailing Address - Country:US
Mailing Address - Phone:615-771-0300
Mailing Address - Fax:615-771-0319
Practice Address - Street 1:320 PREMIER CT
Practice Address - Street 2:STE 220
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8252
Practice Address - Country:US
Practice Address - Phone:615-771-0300
Practice Address - Fax:615-771-0319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000003334291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3403336Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER