Provider Demographics
NPI:1558316125
Name:SUMNER HOMECARE AND HOSPICE, LLC
Entity Type:Organization
Organization Name:SUMNER HOMECARE AND HOSPICE, LLC
Other - Org Name:HOSPICE - GALLATIN
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:NORVELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-328-5515
Mailing Address - Street 1:575 E BLEDSOE ST
Mailing Address - Street 2:STE.2
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-3054
Mailing Address - Country:US
Mailing Address - Phone:615-328-5515
Mailing Address - Fax:615-230-6889
Practice Address - Street 1:575 E BLEDSOE ST
Practice Address - Street 2:STE.2
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3054
Practice Address - Country:US
Practice Address - Phone:615-328-5515
Practice Address - Fax:615-230-6889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000370251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN441513Medicare PIN