Organization
MEDICAL EDUCATION ASSISTANCE CORPORATION
Active
Other names
ETSU OSTEOPOROSIS CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL E LEWIS (EXECUTIVE DIRECTOR)
(423) 433-6050
Entity
Organization
Contact information
Practice address
2109 W MARKET ST, ROOM 143, JOHNSON CITY, TN 37604-6024
(423) 439-8830
(423) 439-8580
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 433-6039
(423) 433-6060
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3790481
MEDICARE
TN
01
—
44X0009820
PORTABLE X-RAY ID NUMBER
TN
Enumeration date
05/18/2007
Last updated
04/25/2016
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