| Peninsula Outpatient Center | |
|
210 Simmons St Maryville TN 37801-4750 | |
| (865) 970-9800 | |
| (865) 380-1461 |
| Full Name | Peninsula Outpatient Center |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 210 Simmons St, Maryville, Tennessee |
| Authorized Official Name and Position | John T Geppi (EXECUTIVE VICE PRESIDENT CFO) |
| Authorized Official Contact | 8653746872 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peninsula Outpatient Center Po Box 1999 Louisville TN 37777-1999 Ph: (865) 970-1295 | Peninsula Outpatient Center 210 Simmons St Maryville TN 37801-4750 Ph: (865) 970-9800 |
| NPI Number | 1699757609 |
|---|---|
| Provider Enumeration Date | 11/16/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699757609 | NPI | - | NPPES |
| 0440173 | Medicaid | TN |
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