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Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Other names
Medical Center Homecare Services
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LYNN KRUTAK (EVP/CFO)
(423) 302-3423
Entity
Organization
Contact information
Practice address
509 MED TECH PKWY, SUITE 200, JOHNSON CITY, TN 37604-2578
(423) 431-6146
(423) 431-5733
Mailing address
311 PRINCETON RD, SUITE 1, JOHNSON CITY, TN 37601-2026
(423) 431-6146
(423) 431-5733
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
0000000271
TN
Other
Enumeration date
08/21/2006
Last updated
02/21/2018
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