Provider Demographics
NPI:1265847982
Name:KENNETT HMA LLC
Entity Type:Organization
Organization Name:KENNETT HMA LLC
Other - Org Name:TWIN RIVERS WOMEN'S CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SWAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-778-8076
Mailing Address - Street 1:PO BOX 689022
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-9022
Mailing Address - Country:US
Mailing Address - Phone:615-778-8532
Mailing Address - Fax:615-628-6877
Practice Address - Street 1:509 SOUTH BYP
Practice Address - Street 2:
Practice Address - City:KENNETT
Practice Address - State:MO
Practice Address - Zip Code:63857-3248
Practice Address - Country:US
Practice Address - Phone:573-888-4310
Practice Address - Fax:573-888-0450
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KENNETT HMA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-23
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty