Organization
SMOKEY MOUNTAIN MEDICAL EQUIPMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES EDWARD PEARCE JR. (OWNER ADMINISTRATOR)
(423) 547-0060
Entity
Organization
Contact information
Practice address
2214 W ELK AVE, ELIZABETHTON, TN 37643-3714
(423) 547-0060
(423) 547-0064
Mailing address
2214 W ELK AVE, ELIZABETHTON, TN 37643-3714
(423) 547-0060
(423) 547-0064
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
000002328
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454924
—
TN
01
—
4100472
BCBS
TN
Enumeration date
11/28/2006
Last updated
11/02/2017
Update your record
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