# MOUNTAIN STATES HEALTH ALLIANCE SYCAMORE SHOALS HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366506925
- **Authorized official:** MR. DENNIS VONDERFECHT (CEO)
- **Authorized official phone:** (423) 431-1009

## Contact information

- **Practice address:** 400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6035
- **Practice address phone:** (423) 431-3548
- **Practice address fax:** (423) 431-3549
- **Mailing address:** 400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6035
- **Mailing address phone:** (423) 431-3548
- **Mailing address fax:** (423) 431-3549

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 0000000012 | TN | Yes |

## Other

- **Enumeration date:** 12/20/2006
- **Last updated:** 08/22/2020