Organization
RURAL HEALTH SERVICES CONSORTIUM OF UPPER EAST TENNESSEE INC
Active
Other names
Bluff City Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WANDA BROWN (CREDENTIALING ADMINISTRATOR)
(423) 272-9163
Entity
Organization
Contact information
Practice address
229 HIGHWAY 19 E, BLUFF CITY, TN 37618-1865
(423) 538-5116
(423) 538-3861
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
—
020845900
BLACK LUNG
—
01
—
3703866
CIGNA / MEDICARE
—
01
—
4122525
BLUECROSS BLUESHIELD
TN
05
—
4448150
—
TN
Enumeration date
07/22/2005
Last updated
10/10/2008
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