1184765190 NPI number — WOMEN'S HEALTH PARTNERS OF EAST TENNESSEE PC

Table of content: (NPI 1184765190)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184765190 NPI number — WOMEN'S HEALTH PARTNERS OF EAST TENNESSEE PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WOMEN'S HEALTH PARTNERS OF EAST TENNESSEE PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WOMEN'S HEALTH ASSOCIATES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184765190
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/08/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 NEW YORK AVE STE 150
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAK RIDGE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37830-5227
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
865-481-0200
Provider Business Mailing Address Fax Number:
865-481-3085

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 NEW YORK AVE STE 150
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAK RIDGE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37830-5227
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-481-0200
Provider Business Practice Location Address Fax Number:
865-481-3085
Provider Enumeration Date:
02/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CRABTREE
Authorized Official First Name:
SANDRA
Authorized Official Middle Name:
COLLIER
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
865-481-0200

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  007939 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3714761 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com