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Organization

STATE OF TENNESSEE

Active
Other names
Campbell 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
162 SHARP PERKINS ROAD, JACKSBORO, TN 37757
(423) 562-8351
(423) 562-1593
Mailing address
PO BOX 59019, KNOXVILLE, TN 37950-9019
(423) 562-8351
(423) 562-1593

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
154308
BLUECROSS BLUESHIELD TN
TN
05
4447836
TN
Enumeration date
02/02/2007
Last updated
08/23/2010
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