| Community Health Of East Tennessee, Inc | |
|
130 Independence Ln Suite 1 La Follette TN 37766-3031 | |
| (423) 562-1705 | |
| (423) 566-3718 |
| Full Name | Community Health Of East Tennessee, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 130 Independence Ln, La Follette, Tennessee |
| Authorized Official Name and Position | Teresa W Dabney (CEO) |
| Authorized Official Contact | 4235621705 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Of East Tennessee, Inc 130 Independence Ln Suite 1 La Follette TN 37766-3031 Ph: (423) 562-1705 | Community Health Of East Tennessee, Inc 130 Independence Ln Suite 1 La Follette TN 37766-3031 Ph: (423) 562-1705 |
| NPI Number | 1750382164 |
|---|---|
| Provider Enumeration Date | 08/09/2005 |
| Last Update Date | 04/15/2019 |
| Medicare PECOS PAC ID | 7618887803 |
|---|---|
| Medicare Enrollment ID | O20030611000019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750382164 | NPI | - | NPPES |
| 441877 | Other | TN | FQHC MEDICARE # |
| 3340196 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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