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NPI Code Detail

MEDICARE: RURAL HEALTH SERVICES CONSORTIUM OF UPPER EAST TENNESSEE INC

MEDICARE: RURAL HEALTH SERVICES CONSORTIUM OF UPPER EAST TENNESSEE INC
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
1261QF0400XFederally Qualified Health Center (FQHC)

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
33703866OTHERCIGNA / MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2020845900OTHERBLACK LUNG
44122525OTHERTNBLUECROSS BLUESHIELD

General Provider Information

NPI Number : 1972503753
Entity Type Code : Organization
Provider Name (Legal Business Name) : RURAL HEALTH SERVICES CONSORTIUM OF UPPER EAST TENNESSEE INC
Provider Business Mailing Address
First Line : PO BOX 850
Second Line :
City : ROGERSVILLE
State : TN
Zip : 37857-0850
Country : US
Telephone Number : 423-272-9163
Fax Number : 423-921-6920
Provider Business Practice Location Address
First Line : 229 HIGHWAY 19 E
Second Line :
City : BLUFF CITY
State : TN
Zip : 37618-1865
Country : US
Telephone Number : 423-538-5116
Fax Number : 423-538-3861
Authorized Official
Title or Position : CREDENTIALING ADMINISTRATOR
Name : MRS. WANDA BROWN
Credential :
Telephone Number : 423-272-9163
Provider Enumeration Date : 07/22/2005
Last Update Date : 10/10/2008

Similar Medicare Providers

1891799631 — MRS. CATHERINE H POWERS FNP
Practice Location Address:
229 HIGHWAY 19 E
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37618-1865
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Practice Fax: 423-538-3861
1841241767 — MICHAEL S ETTER FNP
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1366508681 — DEEPIKA A TUMKUR MD
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1104168327 — MICHAEL E HILL NP-C
Practice Location Address:
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1023485190 — KRISTY RENEE HOUGHTON FNP
Practice Location Address:
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1023563368 — TINA MARIE SMITH FNP
Practice Location Address:
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Directions to “RURAL HEALTH SERVICES CONSORTIUM OF UPPER EAST TENNESSEE INC ” Practice Location

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