Provider Demographics
NPI:1407859754
Name:CARIS HEALTHCARE, LP
Entity Type:Organization
Organization Name:CARIS HEALTHCARE, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAROLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-694-4848
Mailing Address - Street 1:9041 EXECUTIVE PARK DR
Mailing Address - Street 2:STE 275
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4621
Mailing Address - Country:US
Mailing Address - Phone:865-694-4848
Mailing Address - Fax:865-694-7878
Practice Address - Street 1:5120 TELECOM DR
Practice Address - Street 2:STE A&B
Practice Address - City:MILAN
Practice Address - State:TN
Practice Address - Zip Code:38358-3495
Practice Address - Country:US
Practice Address - Phone:731-686-3723
Practice Address - Fax:731-686-8745
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARIS HEALTHCARE, LP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-05-31
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000612251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN10066358OtherAMERIGROUP
TNA3792300OtherAMERICHOICE/UHC
TN0441588Medicaid
TN172723OtherBHP/UNISON
TN4140797OtherBCBS OF TN
TN7167499OtherCIGNA
TN=========005OtherTRICARE
TN0441588Medicaid