Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Other names
Johnson County Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY LEE WILGOCKI (CORP DIRECTOR REIMBURSEMENT)
(423) 431-5794
Entity
Organization
Contact information
Practice address
1987A S SHADY ST, MOUNTAIN CITY, TN 37683-2021
(423) 727-3250
(423) 727-9170
Mailing address
311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
(423) 727-3250
(423) 727-9170
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
0000000130
TN
Other
Enumeration date
08/31/2006
Last updated
07/21/2022
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