| East Tennessee State University | |
|
391 Court Sq Sneedville TN 37869-0723 | |
| (423) 733-2819 | |
| (423) 733-8509 |
| Full Name | East Tennessee State University |
|---|---|
| Speciality | Clinic/Center |
| Location | 391 Court Sq, Sneedville, Tennessee |
| Authorized Official Name and Position | Betty J. King (ACTING CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 4234394414 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Tennessee State University Po Box 70403 365 Stout Drive Johnson City TN 37614-1703 Ph: (423) 439-4515 | East Tennessee State University 391 Court Sq Sneedville TN 37869-0723 Ph: (423) 733-2819 |
| NPI Number | 1326142563 |
|---|---|
| Provider Enumeration Date | 09/08/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 2769394774 |
|---|---|
| Medicare Enrollment ID | O20031002000000 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326142563 | NPI | - | NPPES |
| 3709292 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Secondary |
East Tennessee State University Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2700 Main Street, Sneedville, TN 37869 Phone: 423-733-2819 Fax: 423-733-8509 | |
Wellmont Health System Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1519 Main Street, Sneedville, TN 37869 Phone: 423-733-5070 Fax: 423-733-5075 | |
Rural Health Services Consortium Of Upper East Tennessee Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1861 Main St, Sneedville, TN 37869 Phone: 423-733-2131 Fax: 423-733-1055 | |
Rural Health Services Consortium Of Upper East Tennessee Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 River Rd, Sneedville, TN 37869 Phone: 423-733-2061 Fax: 423-733-1965 |