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Organization

SPECIALTY MEDICAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHRIS HARDEN (CEO)
(865) 560-8889
Entity
Organization

Contact information

Practice address
509 N STATE OF FRANKLIN RD, SUITE C, JOHNSON CITY, TN 37604-8214
(423) 232-8885
(423) 232-8862
Mailing address
7815B OAK RIDGE HWY, KNOXVILLE, TN 37931-2314
(865) 560-8889
(865) 560-8862

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1455072
TN
01
4124497
BLUE CROSS
TN
Enumeration date
03/29/2007
Last updated
07/23/2008
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