Healthcare Provider Details

I. General information

NPI: 1104807510
Provider Name (Legal Business Name): METRO KNOXVILLE HMA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2005
Last Update Date: 04/29/2021
Certification Date: 04/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 E OAK HILL AVE
KNOXVILLE TN
37917-4505
US

IV. Provider business mailing address

900 E OAK HILL AVE
KNOXVILLE TN
37917-4505
US

V. Phone/Fax

Practice location:
  • Phone: 865-545-7793
  • Fax: 865-545-8507
Mailing address:
  • Phone: 865-545-8000
  • Fax: 865-545-7682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number0000000045
License Number StateTN

VIII. Authorized Official

Name: PAULA LALOR
Title or Position: DIRECTOR/DELEGATED OFFICIAL
Credential:
Phone: 629-215-3953