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State Of Tennessee
Public Health or Welfare Agency in Fayetteville, Tennessee
NPI 1922029743

State Of Tennessee is a Public Health or Welfare Agency based in Fayetteville, TN. State Of Tennessee practices in Fayetteville, TN. The NPI Number for State Of Tennessee is 1922029743 and holds a License No. (Tennessee).

The current practice location address for State Of Tennessee is 1000 Washington St W, Fayetteville, TN and can be reached out via phone at 931-433-3231 and via fax at 931-438-1567.

Location: 1000 Washington St W, Fayetteville, TN, 37334-2872
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1922029743
Provider Name
State Of Tennessee
Credential
Provider Entity Type
Organization
Address
1000 Washington St W, Fayetteville, TN, 37334-2872
Phone Number
931-433-3231
Fax Number
931-438-1567
Provider Enumeration Date
07/21/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4448003 05 TN
0141402 01 TN BC/BS & TENNCARE SELECT
4794 01 TN DORAL DENTAL
institution
Provider Business Practice Location Address Details
Address
1000 Washington St W
City
Fayetteville
State
Tennessee
Zip
37334-2872
Phone Number
931-433-3231
Fax Number
931-438-1567
person
Provider Business Mailing Address Details
Address
1000 Washington St W
City
Fayetteville
State
Tennessee
Zip
37334-2872
Phone Number
931-433-3231
Fax Number
931-438-1567
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Public Health or Welfare
Speciality
-
Taxonomy
251K00000X
License No.
()
Definition
Definition to come...
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