Provider Demographics
NPI:1265713275
Name:ONE SOURCE CASE MANAGEMENT SERVICES
Entity type:Organization
Organization Name:ONE SOURCE CASE MANAGEMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:BA, BS
Authorized Official - Phone:606-233-2564
Mailing Address - Street 1:451 MEADOWBROOK RD
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-5470
Mailing Address - Country:US
Mailing Address - Phone:606-233-2564
Mailing Address - Fax:606-436-6160
Practice Address - Street 1:451 MEADOWBROOK RD
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-5470
Practice Address - Country:US
Practice Address - Phone:606-233-2564
Practice Address - Fax:606-436-6160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-03
Last Update Date:2011-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management