Organization
PREMIER SUPPORT SERVICES, INC.
Active
Other names
Interim HealthCare of East Tennessee
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL FRYE (PRESIDENT)
(276) 494-8119
Entity
Organization
Contact information
Practice address
2482 BRIGHTS PIKE, MORRISTOWN, TN 37814-6315
(423) 587-8771
(423) 587-8773
Mailing address
2482 BRIGHTS PIKE, MORRISTOWN, TN 37814-6315
(423) 587-8771
(423) 587-8773
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
0000000010
TN
372500000X
Chore Provider
L000000006169
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0447404
TENNCARE
TN
01
—
3162461
BCBS PROVIDER NUMBER
TN
01
—
4261896
VOLUNTEER STATE HEALTH PLAN
TN
Enumeration date
05/24/2005
Last updated
06/20/2024
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