Organization
RURAL HEALTH SERVICES CONSORTIUM OF UPPER EAST TENNESSEE INC
Active
Other names
Kingsport 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
737 E SEVIER AVE, KINGSPORT, TN 37660-4912
(423) 246-7922
(423) 246-4248
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
—
003
CHAMPUS PROVIDER
—
01
—
023398200
BLACKLUNG
—
01
—
3703862
CIGNA/MEDICARE
—
01
—
4122525
BLUECROSS BLUESHIELD
TN
05
—
4448223
—
TN
Enumeration date
07/22/2005
Last updated
10/10/2008
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