Provider Demographics
NPI:1821629031
Name:BUCKEYE HOME HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:BUCKEYE HOME HEALTH CENTER, INC.
Other - Org Name:BUCKEYE HOME MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:F
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-752-7123
Mailing Address - Street 1:PO BOX 1197
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38556-1197
Mailing Address - Country:US
Mailing Address - Phone:931-752-7123
Mailing Address - Fax:
Practice Address - Street 1:689 MEDICAL PARK DR STE 202
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37772-5797
Practice Address - Country:US
Practice Address - Phone:865-317-1511
Practice Address - Fax:865-317-1577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-28
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ057724Medicaid
TN508OtherDEPARTMENT OF HEALTH LICENSE