Healthcare Provider Details

I. General information

NPI: 1295701217
Provider Name (Legal Business Name): UNICOI COUNTY MEMORIAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 GREENWAY CIRCLE
ERWIN TN
37650
US

IV. Provider business mailing address

100 GREENWAY CIRCLE
ERWIN TN
37650
US

V. Phone/Fax

Practice location:
  • Phone: 423-743-3141
  • Fax: 423-743-1244
Mailing address:
  • Phone: 423-743-3141
  • Fax: 423-743-1244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number0000000119
License Number StateTN

VIII. Authorized Official

Name: MR. JIM PATE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 423-743-3141