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Organization

MOUNTAIN STATES HEALTH ALLIANCE

Active
Other names
Medical Center Homecare Services
Organization subpart
No

Provider details

NPI number
Authorized official
MARY LYNN KRUTAK (EVP/CFO)
(423) 302-3423
Entity
Organization

Contact information

Practice address
509 MED TECH PKWY, SUITE 200, JOHNSON CITY, TN 37604-2578
(423) 431-6146
(423) 431-5733
Mailing address
311 PRINCETON RD, SUITE 1, JOHNSON CITY, TN 37601-2026
(423) 431-6146
(423) 431-5733

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
0000000271
TN

Other

Enumeration date
08/21/2006
Last updated
02/21/2018
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