# MOUNTAIN STATES HEALTH ALLIANCE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MSMG FP ST PA, BHRHC St. Paul, BHRHC ST PAUL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386813616
- **Authorized official:** JUANITA HARWOOD (DIRECTOR)
- **Authorized official phone:** (423) 392-6565

## Contact information

- **Practice address:** 16431 WISE ST, ST PAUL, VA 24283
- **Practice address phone:** (276) 762-2300
- **Practice address fax:** (276) 762-0612
- **Mailing address:** 1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
- **Mailing address phone:** (423) 302-6567
- **Mailing address fax:** (276) 762-0612

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/20/2008
- **Last updated:** 08/12/2024