Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Other names
Johnson County Community Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE EDWIN HILTON (EVP/CFO)
(423) 302-3467
Entity
Organization
Contact information
Practice address
1901 S SHADY ST, MOUNTAIN CITY, TN 37683-2021
(423) 727-1100
(423) 727-1112
Mailing address
311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
(423) 727-1100
(423) 727-1112
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
0000000038
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004413041
—
VA
05
—
0441304
—
TN
05
—
091618800
—
FL
01
—
100020317
PHP
—
05
—
11500B
—
SC
01
—
2669036
CIGNA
—
05
—
3810001915
—
WV
01
—
4001915
BLUE CROSS
—
05
—
4401304
—
NC
05
—
93633835A
—
GA
01
—
A3768308
JOHN DEERE
—
Enumeration date
09/08/2006
Last updated
04/16/2024
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