1457137234 NPI number — THVC SERVICES OF AR PA

Table of content: (NPI 1457137234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457137234 NPI number — THVC SERVICES OF AR PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THVC SERVICES OF AR PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457137234
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
265 BROOKVIEW CENTRE WAY STE 203
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KNOXVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37919-4052
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
865-693-1000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 W CAPITOL AVE STE 1700
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LITTLE ROCK
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72201-3438
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-693-1000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/06/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
THOMPSON
Authorized Official First Name:
STANLEY
Authorized Official Middle Name:
CRAIG
Authorized Official Title or Position:
OWNER/PRESIDENT
Authorized Official Telephone Number:
865-693-1000

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LF0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)