| Mountain States Health Alliance | |
|
1901 S Shady St Mountain City TN 37683-2021 | |
| (423) 727-1103 | |
| (423) 727-1140 |
| Full Name | Mountain States Health Alliance |
|---|---|
| Speciality | Clinic/Center |
| Location | 1901 S Shady St, Mountain City, Tennessee |
| Authorized Official Name and Position | Shane Edwin Hilton (EVP/CFO) |
| Authorized Official Contact | 4233023467 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain States Health Alliance 311 Princeton Rd Ste 1 Johnson City TN 37601-2026 Ph: (423) 727-1103 | Mountain States Health Alliance 1901 S Shady St Mountain City TN 37683-2021 Ph: (423) 727-1103 |
| NPI Number | 1518079532 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 04/16/2024 |
| Medicare PECOS PAC ID | 6002726718 |
|---|---|
| Medicare Enrollment ID | O20030507000035 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518079532 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 0000000038 (Tennessee) | Primary |
Mountain States Health Alliance Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1901 S Shady St, Mountain City, TN 37683 Phone: 423-727-1100 Fax: 423-727-1105 | |
Blue Ridge Medical Management Corporation 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 | |
East Tennessee State University Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1901 S Shady Street, Mountain City, TN 37683 Phone: 423-727-1150 Fax: 423-727-1152 | |
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 | |
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 |