Provider Demographics
NPI:1982630653
Name:SAINT THOMAS HOME HEALTH
Entity Type:Organization
Organization Name:SAINT THOMAS HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HULLETT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:931-729-4500
Mailing Address - Street 1:135 E SWAN ST
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37033-1417
Mailing Address - Country:US
Mailing Address - Phone:931-729-4500
Mailing Address - Fax:931-729-9000
Practice Address - Street 1:135 E SWAN ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37033-1417
Practice Address - Country:US
Practice Address - Phone:931-729-4500
Practice Address - Fax:931-729-9000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000125251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN447424Medicare ID - Type UnspecifiedPROVIDER NUMBER