RURAL HEALTH SERVICES CONSORTIUM OF UPPER EAST TENNESSEE INC NPI 1396745162

NPI Information

NPI: 1396745162
Provider Name: RURAL HEALTH SERVICES CONSORTIUM OF UPPER EAST TENNESSEE INC

Doing Business As: DRY CREEK MEDICAL CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
1826 N MAIN AVE
ERWIN, TN
ZIP 37650
Phone: (423) 743-6135
Get Directions

RURAL HEALTH SERVICES CONSORTIUM OF UPPER EAST TENNESSEE INC is a federally qualified health center (fqhc) clinic center in Erwin, TN. RURAL HEALTH SERVICES CONSORTIUM OF UPPER EAST TENNESSEE INC NPI is 1396745162. The provider is registered as an organization entity type.
The provider Is Doing Business As Dry Creek Medical Center.

The provider's business location address is:

1826 N MAIN AVE
ERWIN, TN
ZIP 37650-932
Phone: (423) 743-6135
Fax: (423) 743-0035

The provider's authorized official is Linda W Buck .
The authorized official title is Ceo and has the following contact phone number (423) 272-9163.

The CLIA number assigned to this NPI record is 44D0310945 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/22/2005 and was last updated on 10/10/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	4122525	OTHER	TENNESSEE	BLUECROSS BLUESHIELD
2	3703865	MEDICARE PIN
3	002	OTHER		CHAMPUS PROVIDER
4	020021000	OTHER		BLACKLUNG
5	3703868	OTHER		CIGNA MEDICARE
6	441813	MEDICARE ID-TYPE UNSPECIFIED
7	4448096	MEDICAID	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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