Healthcare Provider Details

I. General information

NPI: 1770792095
Provider Name (Legal Business Name): MORRISTOWN HAMBLEN HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 05/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1621 W MORRIS BLVD SUITE B
MORRISTOWN TN
37813-2832
US

IV. Provider business mailing address

1621 W MORRIS BLVD SUITE B
MORRISTOWN TN
37813-2832
US

V. Phone/Fax

Practice location:
  • Phone: 423-587-2443
  • Fax: 423-586-9988
Mailing address:
  • Phone: 423-587-2443
  • Fax: 423-586-9988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number207Q00000X
License Number StateTN

VIII. Authorized Official

Name: MR. MAX OWENS
Title or Position: CFO
Credential:
Phone: 423-522-4439