Organization Name: | STATE OF TENNESSEE |
NPI Number: | 1437203809 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARIANNE F SHARP (REGIONAL ACCOUNTANT) |
Mailing Address: | 1362 N Gateway Ave Rockwood |
State: | TN US |
Postal Code: | 378544108 |
Phone Number: | 8653541220 |
Fax Number: | 8653540112 |
NPI Enumeration Date: | 01/23/2007 |
NPI Last Update Date: | 11/16/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP0905X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Public Health, State or Local |
Taxonomy Definition: |