Healthcare Provider Details

I. General information

NPI: 1609860659
Provider Name (Legal Business Name): FORT LOUDOUN MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2005
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 FORT LOUDOUN MEDICAL CENTER DR
LENOIR CITY TN
37772-5673
US

IV. Provider business mailing address

PO BOX 440016
NASHVILLE TN
37244-0016
US

V. Phone/Fax

Practice location:
  • Phone: 865-458-8222
  • Fax:
Mailing address:
  • Phone: 865-374-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number0000000084
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: ROBERT BOOS
Title or Position: SVP REVENUE CYCLE
Credential:
Phone: 865-374-3000