Organization Name: | EAST TENNESSEE STATE UNIVERSITY |
NPI Number: | 1295779361 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID D. COLLINS (CFO, VP FINANCE & ADMINISTRATION) |
Mailing Address: | 1901 S Shady Street Mountain City |
State: | TN US |
Postal Code: | 376832601 |
Phone Number: | 4237271150 |
Fax Number: | 4237271152 |
NPI Enumeration Date: | 06/16/2006 |
NPI Last Update Date: | 06/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |