Provider Demographics
NPI:1245277110
Name:NHC HEALTHCARE-SMITHVILLE LLC
Entity type:Organization
Organization Name:NHC HEALTHCARE-SMITHVILLE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF LLC
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:G
Authorized Official - Last Name:BIDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-893-2602
Mailing Address - Street 1:825 FISHER AVE
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37166-2140
Mailing Address - Country:US
Mailing Address - Phone:615-597-4284
Mailing Address - Fax:
Practice Address - Street 1:825 FISHER AVE
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37166-2140
Practice Address - Country:US
Practice Address - Phone:615-597-4284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL HEALTHCARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-01
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
310400000X
TN071314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
0414520OtherHEALTH SPRING
TN1000686OtherBCBS TN
TN0445116Medicaid
TN7440188Medicaid
445116Medicare Oscar/Certification