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Organization

RURAL HEALTH SERVICES CONSORTIUM OF UPPER EAST TENNESSEE INC

Active
Other names
Roan Mountain Medical Center
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LINDA W BUCK (CEO)
(423) 272-9163
Entity
Organization

Contact information

Practice address
152 HIGHWAY 143, ROAN MOUNTAIN, TN 37687-3002
(423) 772-3276
(423) 772-4816
Mailing address
PO BOX 850, ROGERSVILLE, TN 37857-0850
(423) 272-9163
(423) 921-6920

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
005
CHAMPUS PROVIDER
01
020250900
BLACKLUNG
01
4122525
BLUECROSS BLUESHIELD
TN
05
4448070
TN
Enumeration date
07/22/2005
Last updated
10/10/2008
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