| |
1861 Main St Sneedville TN 37869-3645 | |
(423) 733-2131 | |
(423) 733-1055 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 1861 Main St, Sneedville, 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 |
---|---|
Po Box 850 Rogersville TN 37857-0850 Ph: (423) 272-9163 | 1861 Main St Sneedville TN 37869-3645 Ph: (423) 733-2131 |
NPI Number | 1669472460 |
---|---|
Provider Enumeration Date | 07/22/2005 |
Last Update Date | 10/10/2008 |
Medicare PECOS PAC ID | 0941118111 |
---|---|
Medicare Enrollment ID | O20030709000036 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669472460 | NPI | - | NPPES |
008 | Other | CHAMPUS PROVIDER | |
4122525 | Other | TN | BLUECROSS BLUESHIELD |
021135900 | Other | BLACKLUNG | |
3703864 | Other | CIGNA/MEDICARE | |
4448160 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |