Organization
JELLICO COMMUNITY HOSPITAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYN GHULAM (CONTROLLER)
(423) 784-1334
Entity
Organization
Contact information
Practice address
188 HOSPITAL LANE, JELLICO, TN 37762-4400
(423) 784-1272
(423) 784-1136
Mailing address
188 HOSPITAL LANE, JELLICO, TN 37762-4400
(423) 784-1272
(423) 784-1136
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0056883
BLUECARE
TN
Enumeration date
06/07/2010
Last updated
03/10/2016
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