# STATE OF TENNESSEE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Polk County Health Department - Benton
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962549808
- **Authorized official:** MR. RICHARD W MCCARTHY MBA (ACCOUNTING MANAGER)
- **Authorized official phone:** (423) 634-5832

## Contact information

- **Practice address:** 2279 PARKSVILLE RD, BENTON, TN 37307-3803
- **Practice address phone:** (423) 338-4533
- **Practice address fax:** (423) 338-1959
- **Mailing address:** 2279 PARKSVILLE RD, BENTON, TN 37307-3803
- **Mailing address phone:** (423) 338-4533
- **Mailing address fax:** (423) 338-1959

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 01/31/2007
- **Last updated:** 02/08/2022