Basic Information
| Provider Information | |||||||||
| NPI: | 1528444825 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | RURAL HEALTH SERVICES CONSORTIUM OF UPPER EAST TENNESSEE INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | RURAL HEALTH SERVICES PHARMACY/DURABLE MEDICAL EQUIPMENT | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 850 | ||||||||
| Address2: | |||||||||
| City: | ROGERSVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 378570850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4239211824 | ||||||||
| FaxNumber: | 4239211696 | ||||||||
| Practice Location | |||||||||
| Address1: | 4307 HIGHWAY 66 S | ||||||||
| Address2: | |||||||||
| City: | ROGERSVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 378573155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4239211650 | ||||||||
| FaxNumber: | 4239211696 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2015 | ||||||||
| LastUpdateDate: | 04/21/2016 | ||||||||
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| AuthorizedOfficialLastName: | BUCK | ||||||||
| AuthorizedOfficialFirstName: | LINDA | ||||||||
| AuthorizedOfficialMiddleName: | W | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 4232729163 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.