MEDICARE: UNITED COMMONWEALTH FEDERATION ALLIANCE CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor

General Provider Information

NPI Number	:	1518409978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED COMMONWEALTH FEDERATION ALLIANCE CORP

Provider Business Mailing Address
First Line	:	9111 EXECUTIVE PARK DR
Second Line	:	SUITE D200
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-4514
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9111 EXECUTIVE PARK DR
Second Line	:	SUITE D200
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-4514
Country	:	US
Telephone Number	:	423-271-9911
Fax Number	:

Authorized Official
Title or Position	:	CHIEF CHAIR
Name	:	THEO S STEPHENS
Credential	:
Telephone Number	:	423-271-9911

Provider Enumeration Date	:	11/16/2016
Last Update Date	:	11/16/2016

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