institution
East Tennessee State University
Federally Qualified Health Center (FQHC) in Johnson City, Tennessee
NPI 1982905576

East Tennessee State University is a Federally Qualified Health Center (FQHC) based in Johnson City, TN and is specialized in Federally Qualified Health Center (FQHC). East Tennessee State University practices in Johnson City, TN. The NPI Number for East Tennessee State University is 1982905576 and holds a License No. (Tennessee).

The current practice location address for East Tennessee State University is 1134-1136 E. Main Street, Johnson City, TN and can be reached out via phone at 423-722-0808 and via fax at 423-929-2930.

Location: 1134-1136 E. Main Street, Johnson City, TN, 37614-1703
institution
Provider Profile Details
NPI Number
1982905576
Provider Name
East Tennessee State University
Credential
Provider Entity Type
Organization
Address
1134-1136 E. Main Street, Johnson City, TN, 37614-1703
Phone Number
423-722-0808
Fax Number
423-929-2930
Provider Enumeration Date
11/12/2010
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
1522314 05 TN
institution
Provider Business Practice Location Address Details
Address
1134-1136 E. Main Street
City
State
Zip
37601
Phone Number
423-722-0808
Fax Number
423-929-2930
person
Provider Business Mailing Address Details
Address
1134-1136 E. Main Street
City
State
Zip
37601
Phone Number
423-722-0808
Fax Number
423-929-2930
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
License No.
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Definition
Definition to come...
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