# VA MEDICAL CENTER MOUNTAIN HOME, TN

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

## Provider details

- **NPI number:** 1427201813
- **Authorized official:** MR. JOHN FRANK TESTERMAN III PA-C (PHYSICAN ASSISTANT)
- **Authorized official phone:** (423) 926-1171

## Contact information

- **Practice address:** 1ST STREET BLDG 204, JAMES H. QUILLEN VA MEDICAL CENTER EMERGENCY DEPT, JOHNSON CITY, TN 37684-4000
- **Practice address phone:** (423) 926-1171
- **Mailing address:** 1ST STREET, BLDG 204, JAMES H. QUILLEN VA MEDICAL CENTER EMERGENCY DEPT, JOHNSON CITY, TN 37684
- **Mailing address phone:** (423) 926-1171

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | TNPA036 | TN | Yes |

## Other

- **Enumeration date:** 10/29/2008
- **Last updated:** 10/29/2008