Healthcare Provider Details

I. General information

NPI: 1144125204
Provider Name (Legal Business Name): CAMPBELL COUNTY HMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

389 FORGE RIDGE RD
HARROGATE TN
37752-7730
US

IV. Provider business mailing address

923 E CENTRAL AVE
LA FOLLETTE TN
37766-2768
US

V. Phone/Fax

Practice location:
  • Phone: 423-869-0725
  • Fax: 423-869-9275
Mailing address:
  • Phone: 423-907-1200
  • Fax: 423-907-1163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0200X
TaxonomyOncology Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: PAULA LALOR
Title or Position: SENIOR DIRECTOR
Credential:
Phone: 629-215-3953