Roan Mountain Medical Center | |
152 Highway 143 Roan Mountain TN 37687-3002 | |
(423) 772-3276 | |
(423) 772-4816 |
Full Name | Roan Mountain Medical Center |
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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 |
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Roan Mountain Medical Center Po Box 850 Rogersville TN 37857-0850 Ph: (423) 272-9163 | Roan Mountain Medical Center 152 Highway 143 Roan Mountain TN 37687-3002 Ph: (423) 772-3276 |
NPI Number | 1568462372 |
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Provider Enumeration Date | 07/22/2005 |
Last Update Date | 10/10/2008 |
Medicare PECOS PAC ID | 0941118111 |
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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 |