Organization
MOUNTAIN STATES HEALTH ALLIANCE
Active
Parent organization
MOUNTAIN STATES HEALTH ALLIANCE
Other names
Johnson City Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOUNTAIN STATES HEALTH ALLIANCE
Authorized official
MARY LYNN KRUTAK (EVP/CFO)
(423) 302-3423
Entity
Organization
Contact information
Practice address
400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6035
(423) 431-6111
(423) 431-3549
Mailing address
311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
(423) 431-6111
(423) 431-3549
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
—
—
Other
Enumeration date
11/16/2017
Last updated
03/14/2018
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