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General NPI Number Information
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NPI Number | 1770690729
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Entity Type | Organization
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Legal Business Name | ROANE MEDICAL CENTER
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 01/14/2008
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Provider Practice Location Address
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Address Line | 412 DEVONIA ST
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City | HARRIMAN
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State | TN
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Zip | 37748-2009
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Country | US
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Telephone | 865-882-1323
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Fax | 865-882-4463
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Provider Business Mailing Address
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Address Line | 412 DEVONIA ST P.O. BOX 489
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City | HARRIMAN
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State | TN
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Zip | 37748-2009
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Country | US
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Telephone | 865-882-1323
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Fax | 865-882-4463
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Authorized Official
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Title or Position | C.F.O.
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Name | MRS. JANICE K BARDILL
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Credential | C.P.A.
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Telephone | 865-882-4377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number | 98
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License Number State | TN
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