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Organization

STATE OF TENNESSEE

Active
Other names
Jefferson County Health Department
Organization subpart
No

Provider details

NPI number
Authorized official
MARIANNE F SHARP (REGIONAL ACCOUNTANT)
(865) 549-5266
Entity
Organization

Contact information

Practice address
931 INDUSTRIAL PARK RD, SUITE 200, DANDRIDGE, TN 37725-4701
(865) 397-3930
(865) 397-1246
Mailing address
PO BOX 59019, KNOXVILLE, TN 37950-9019
(865) 549-5266
(865) 594-8919

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
150560
BLUECROSSBLUESHIELD TN
TN
05
4447831
TN
Enumeration date
02/02/2007
Last updated
11/16/2009
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