Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Other names
Ballad Health Homecare
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE EDWIN HILTON (EVP/CFO)
(423) 302-3467
Entity
Organization
Contact information
Practice address
509 MED TECH PKWY STE 200, JOHNSON CITY, TN 37604
(423) 431-6146
(423) 431-5288
Mailing address
311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
(423) 431-6146
(423) 431-5288
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
269
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4149709
BLUE CROSS
TN
05
—
447240
—
TN
Enumeration date
10/23/2006
Last updated
04/16/2024
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