Provider Demographics
NPI:1033866769
Name:EAST TENNESSEE MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:EAST TENNESSEE MEDICAL SERVICES LLC
Other - Org Name:EAST TENNESSEE MEDICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL / MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHASE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:865-603-2782
Mailing Address - Street 1:524 ANDREW JOHNSON HWY
Mailing Address - Street 2:
Mailing Address - City:STRAWBERRY PLAINS
Mailing Address - State:TN
Mailing Address - Zip Code:37871-1015
Mailing Address - Country:US
Mailing Address - Phone:865-933-4149
Mailing Address - Fax:865-933-4037
Practice Address - Street 1:524 ANDREW JOHNSON HWY
Practice Address - Street 2:
Practice Address - City:STRAWBERRY PLAINS
Practice Address - State:TN
Practice Address - Zip Code:37871-1015
Practice Address - Country:US
Practice Address - Phone:865-933-4149
Practice Address - Fax:865-933-4037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-02
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty