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General NPI Number Information
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NPI Number | 1649266974
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Entity Type | Organization
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Legal Business Name | PRISMA HEALTH - BLOUNT MEMORIAL HOSPITAL INC.
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Dates
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Enumeration Date | 09/22/2005
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 1095 E LAMAR ALEXANDER PKWY
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City | MARYVILLE
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State | TN
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Zip | 37804-5134
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Country | US
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Telephone | 865-981-2160
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Fax | 865-977-4616
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Provider Business Mailing Address
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Address Line | 1095 E LAMAR ALEXANDER PKWY
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City | MARYVILLE
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State | TN
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Zip | 37804-5134
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Country | US
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Telephone | 865-981-2160
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Fax | 865-977-4616
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Authorized Official
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Title or Position | DIRECTOR PROVIDER ENROLLMENT & CVO
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Name | KRISTI ANN LAWRENCE
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Credential |
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Telephone | 864-522-8611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 447469
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License Number State | TN
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