Provider Demographics
NPI:1689355620
Name:SHALOM HOSPICE OF GREATER KNOXVILLE LLC
Entity Type:Organization
Organization Name:SHALOM HOSPICE OF GREATER KNOXVILLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-499-9977
Mailing Address - Street 1:8351 E WALKER SPRINGS LN STE 402
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-3142
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:865-381-1204
Practice Address - Street 1:8351 E WALKER SPRINGS LN STE 402
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-3142
Practice Address - Country:US
Practice Address - Phone:510-499-9977
Practice Address - Fax:865-381-1204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based