Organization Name: | MOUNTAIN STATES HEALTH ALLIANCE |
NPI Number: | 1497859789 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARY LYNN KRUTAK (SVP/CFO) |
Mailing Address: | 1901 S Shady St Mountain City |
State: | TN US |
Postal Code: | 376832021 |
Phone Number: | 4237271100 |
Fax Number: | 4237271112 |
NPI Enumeration Date: | 09/08/2006 |
NPI Last Update Date: | 10/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 282NC0060X |
License Number: | 0000000038 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Hospitals |
Taxonomy Classification: | General Acute Care Hospital |
Taxonomy Specialization: | Critical Access |
Taxonomy Definition: |