Provider Demographics
NPI:1093940215
Name:GERATRIC ASSESMENT PROGRAM
Entity Type:Organization
Organization Name:GERATRIC ASSESMENT PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:NELMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-549-4892
Mailing Address - Street 1:BAPTIST MEDICAL TOWER, BLOUNT AVEUNUE
Mailing Address - Street 2:SUITE 650
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1632
Mailing Address - Country:US
Mailing Address - Phone:865-632-5058
Mailing Address - Fax:865-549-2166
Practice Address - Street 1:BAPTIST MEDICAL TOWER, BLOUNT AVEUNUE
Practice Address - Street 2:SUITE 650
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1632
Practice Address - Country:US
Practice Address - Phone:865-632-5058
Practice Address - Fax:865-549-2166
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY PHYSICIAN SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center