| Rural Health Services Consortium Of Upper East Tennessee Inc | |
|
152 Highway 143 Roan Mountain TN 37687-3002 | |
| (423) 772-3276 | |
| (423) 772-4816 |
| Full Name | Rural Health Services Consortium Of Upper East Tennessee Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 152 Highway 143, Roan Mountain, Tennessee |
| Authorized Official Name and Position | Linda W Buck (CEO) |
| Authorized Official Contact | 4232729163 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rural Health Services Consortium Of Upper East Tennessee Inc Po Box 850 Rogersville TN 37857-0850 Ph: (423) 272-9163 | Rural Health Services Consortium Of Upper East Tennessee Inc 152 Highway 143 Roan Mountain TN 37687-3002 Ph: (423) 772-3276 |
| NPI Number | 1568462372 |
|---|---|
| Provider Enumeration Date | 07/22/2005 |
| Last Update Date | 10/10/2008 |
| Medicare PECOS PAC ID | 0941118111 |
|---|---|
| Medicare Enrollment ID | O20080930000380 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568462372 | NPI | - | NPPES |
| 4122525 | Other | TN | BLUECROSS BLUESHIELD |
| 005 | Other | CHAMPUS PROVIDER | |
| 020250900 | Other | BLACKLUNG | |
| 4448070 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |