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General NPI Number Information
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NPI Number | 1841518867
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Entity Type | Organization
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Legal Business Name | FRONTIER HEALTH
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Dates
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Enumeration Date | 05/14/2010
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Last Update Date | 05/14/2010
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Provider Practice Location Address
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Address Line | 616 E CHURCH ST
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City | GREENEVILLE
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State | TN
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Zip | 37745-5084
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Country | US
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Telephone | 423-639-3213
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Fax | 423-467-3644
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Provider Business Mailing Address
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Address Line | PO BOX 9054
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City | GRAY
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State | TN
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Zip | 37615-9054
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Country | US
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Telephone | 423-467-3600
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Fax | 423-467-3644
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MR. E. DOUGLAS VARNEY
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Credential |
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Telephone | 423-467-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | I000000006376
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | I000000006376
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License Number State | TN
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