Healthcare Provider Details
I. General information
NPI: 1760651301
Provider Name (Legal Business Name): SCOTT COUNTY HMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/28/2008
Last Update Date: 03/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18797 ALBERTA ST
ONEIDA TN
37841-2127
US
IV. Provider business mailing address
18797 ALBERTA ST
ONEIDA TN
37841-2127
US
V. Phone/Fax
- Phone: 423-286-5300
- Fax: 423-286-5661
- Phone: 423-569-8521
- Fax: 423-569-2857
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | 0000000101 |
| License Number State | TN |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282NC0060X |
| Taxonomy | Critical Access Hospital |
| License Number | 0000000101 |
| License Number State | TN |
VIII. Authorized Official
Name:
LINDA
A.
EPSTEIN
Title or Position: VICE PRESIDENT
Credential: ESQ
Phone: 239-552-3490