Healthcare Provider Details

I. General information

NPI: 1720099419
Provider Name (Legal Business Name): MORGAN COUNTY HEALTH COUNCIL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 12/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 OLD MILL ROAD
WARTBURG TN
37887
US

IV. Provider business mailing address

224 OLD MILL ROAD P.O. BOX 408
WARTBURG TN
37887
US

V. Phone/Fax

Practice location:
  • Phone: 423-346-6221
  • Fax: 423-346-5565
Mailing address:
  • Phone: 423-346-6221
  • Fax: 423-346-5565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MRS. KELLIE JONES
Title or Position: OFFICE MANAGER
Credential:
Phone: 423-346-6221