# COPPER BASIN COMMUNITY HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Copper Basin Family Healthcare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275851602
- **Authorized official:** ANNA CLARK (CEO)
- **Authorized official phone:** (423) 548-1500

## Contact information

- **Practice address:** 144 MEDICAL CENTER DR, BLDG. C, COPPERHILL, TN 37317-5005
- **Practice address phone:** (423) 496-5511
- **Practice address fax:** (423) 548-1520
- **Mailing address:** 144 MEDICAL CENTER DR, BLDG. C, COPPERHILL, TN 37317-5005
- **Mailing address phone:** (423) 496-5511

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/10/2010
- **Last updated:** 01/20/2017