Provider Demographics
NPI:1235135062
Name:SENIOR HEALTH GROUP, INC.
Entity Type:Organization
Organization Name:SENIOR HEALTH GROUP, INC.
Other - Org Name:MEDCAREMD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:KIMBERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-349-1998
Mailing Address - Street 1:176 THOMPSON LN
Mailing Address - Street 2:SUITE G-5
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-2448
Mailing Address - Country:US
Mailing Address - Phone:615-349-1998
Mailing Address - Fax:888-428-2350
Practice Address - Street 1:176 THOMPSON LN
Practice Address - Street 2:SUITE G-5
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-2448
Practice Address - Country:US
Practice Address - Phone:615-349-1998
Practice Address - Fax:888-428-2350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-27
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1454918Medicaid
TN4999990002Medicare NSC