| Mountain City Extended Hours Health Center | |
|
1901 S Shady Street Mountain City TN 37683-2601 | |
| (423) 727-1150 | |
| (423) 727-1152 |
| Full Name | Mountain City Extended Hours Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1901 S Shady Street, Mountain City, 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 |
|---|---|
| Mountain City Extended Hours Health Center Po Box 70403 Johnson City TN 37614-1703 Ph: (423) 439-4515 | Mountain City Extended Hours Health Center 1901 S Shady Street Mountain City TN 37683-2601 Ph: (423) 727-1150 |
| NPI Number | 1295779361 |
|---|---|
| Provider Enumeration Date | 06/16/2006 |
| Last Update Date | 09/22/2017 |
| Medicare PECOS PAC ID | 2769394774 |
|---|---|
| Medicare Enrollment ID | O20090202000087 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295779361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Mary Anne Brady |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1083011035 PECOS PAC ID: 8628395738 Enrollment ID: I20180425000498 |
Msmg Fp Im Mtn Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1901 S Shady St, Mountain City, TN 37683 Phone: 423-727-1100 Fax: 423-727-1105 | |
Msmg Ip Services Johnson County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 S Shady St Ste A, Mountain City, TN 37683 Phone: 423-727-1103 Fax: 423-727-1140 | |
Donald F Tarr Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4200 Cold Springs Rd, Mountain City, TN 37683 Phone: 423-727-7743 Fax: 423-727-5509 | |
Donald R Walters Mdpc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 212 N Church St, Mountain City, TN 37683 Phone: 423-727-7711 Fax: 423-727-0209 | |
Bhrhc Mtncity Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1901 S Shady St, Mountain City, TN 37683 Phone: 423-727-1103 Fax: 423-727-1140 | |
Northeast Tennessee Health And Home Care Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 Kellogg Dr, Mountain City, TN 37683 Phone: 423-460-3232 Fax: 423-460-3234 |