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Organization

STATE OF TENNESSEE

Active
Other names
Roane 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
1362 N GATEWAY AVE, ROCKWOOD, TN 37854-4108
(865) 354-1220
(865) 354-0112
Mailing address
PO BOX 59019, KNOXVILLE, TN 37950-9019
(865) 549-5266
(865) 594-8919

Taxonomy

Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2008151
BLUECROSS BLUESHIELD
TN
05
4447825
TN
Enumeration date
01/23/2007
Last updated
11/16/2009
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