| Cumberland Home Doctors, Llc | |
|
1060 Golden Mountain Rd Sparta TN 38583-1120 | |
| (931) 933-5743 | |
| Not Available |
| Full Name | Cumberland Home Doctors, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1060 Golden Mountain Rd, Sparta, Tennessee |
| Authorized Official Name and Position | Geneth Wolfer Do (OWNER, CEO) |
| Authorized Official Contact | 9319335743 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cumberland Home Doctors, Llc 1060 Golden Mountain Rd Sparta TN 38583-1120 Ph: (931) 933-5743 | Cumberland Home Doctors, Llc 1060 Golden Mountain Rd Sparta TN 38583-1120 Ph: (931) 933-5743 |
| NPI Number | 1740727916 |
|---|---|
| Provider Enumeration Date | 01/26/2017 |
| Last Update Date | 01/26/2017 |
| Medicare PECOS PAC ID | 5991080160 |
|---|---|
| Medicare Enrollment ID | O20170330002082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740727916 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 612 (Tennessee) | Primary |
| Provider Name | Geneth K Wolfer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053462168 PECOS PAC ID: 9032217948 Enrollment ID: I20070530000597 |
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