Healthcare Provider Details

I. General information

NPI: 1952508095
Provider Name (Legal Business Name): FORT SANDERS REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 W CLINCH AVE
KNOXVILLE TN
37916-2307
US

IV. Provider business mailing address

1901 W CLINCH AVE
KNOXVILLE TN
37916-2307
US

V. Phone/Fax

Practice location:
  • Phone: 865-541-1144
  • Fax: 865-541-1786
Mailing address:
  • Phone: 865-541-1144
  • Fax: 865-541-1786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number570
License Number StateTN

VIII. Authorized Official

Name: TIMOTHY MARK SMITH
Title or Position: DIRECTOR OF PHARMACY
Credential: PHARMD
Phone: 865-541-1304