Organization
STATE OF TENNESSEE
Active
Other names
Monroe County Health Department
Organization subpart
No
Provider details
NPI number
Authorized official
MARIANNE F SHARP (REGIONAL ACCOUNTANT)
(865) 549-5266
Entity
Organization
Contact information
Practice address
3469 NEW HIGHWAY 68, MADISONVILLE, TN 37354
(423) 442-3993
(423) 442-9468
Mailing address
PO BOX 59019, KNOXVILLE, TN 37950-9019
(865) 549-5266
(865) 594-8919
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
152400
BLUECROSS BLUESHIELD TN
TN
05
—
4447828
—
TN
Enumeration date
01/24/2007
Last updated
11/16/2009
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