MEDICARE: FORT SANDERS REGIONAL MEDICAL CENTER

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	333600000X	Pharmacy
2	3336C0004X	Compounding Pharmacy
3	3336S0011X	Specialty Pharmacy
4	3336H0001X	Home Infusion Therapy Pharmacy	570	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2092051	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629066378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORT SANDERS REGIONAL MEDICAL CENTER

Provider Business Mailing Address
First Line	:	1420 CENTERPOINT BLVD
Second Line	:	BUILDING C
City	:	KNOXVILLE
State	:	TN
Zip	:	37932-1960
Country	:	US
Telephone Number	:	865-374-5354
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901 W CLINCH AVE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37916-2307
Country	:	US
Telephone Number	:	865-331-1860
Fax Number	:	865-331-1861

Authorized Official
Title or Position	:	VP, REVENUE CYCLE
Name	:	RICK CARRINGER
Credential	:	CPA
Telephone Number	:	865-374-3000

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	06/10/2025

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