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General NPI Number Information
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NPI Number | 1033383617
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Entity Type | Organization
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Legal Business Name | ST. MARY'S MEDICAL CENTER OF SCOTT COUNTY, INC.
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Dates
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Enumeration Date | 04/15/2008
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 18797 ALBERTA ST
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City | ONEIDA
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State | TN
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Zip | 37841-2127
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Country | US
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Telephone | 423-569-5821
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Fax | 423-569-5460
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Provider Business Mailing Address
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Address Line | 18797 ALBERTA ST
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City | ONEIDA
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State | TN
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Zip | 37841-2127
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Country | US
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Telephone | 423-569-5821
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Fax | 423-569-5460
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DEBRA K LONDON
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Credential |
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Telephone | 865-545-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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