Provider Demographics
NPI:1265571194
Name:FELLOWSHIP ASSOC. OF RESOURCE MINISTRY
Entity type:Organization
Organization Name:FELLOWSHIP ASSOC. OF RESOURCE MINISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BEELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-933-8752
Mailing Address - Street 1:PO BOX 74
Mailing Address - Street 2:
Mailing Address - City:KODAK
Mailing Address - State:TN
Mailing Address - Zip Code:37764-0074
Mailing Address - Country:US
Mailing Address - Phone:865-933-8752
Mailing Address - Fax:865-933-4230
Practice Address - Street 1:2941 DOUGLAS DAM RD
Practice Address - Street 2:
Practice Address - City:KODAK
Practice Address - State:TN
Practice Address - Zip Code:37764-2027
Practice Address - Country:US
Practice Address - Phone:865-933-8752
Practice Address - Fax:865-933-4230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4138591OtherBLUECROSS & BLUESHIELD
TNT000217Medicaid