Provider Demographics
NPI:1114990744
Name:METRO KNOXVILLE HMA, LLC
Entity Type:Organization
Organization Name:METRO KNOXVILLE HMA, LLC
Other - Org Name:TENNOVA HEALTHCARE ASSOCIATE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY OPERATIONS LEADER
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOLKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-545-8905
Mailing Address - Street 1:900 E OAK HILL AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-4505
Mailing Address - Country:US
Mailing Address - Phone:865-545-8905
Mailing Address - Fax:865-545-8909
Practice Address - Street 1:900 E OAK HILL AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-4505
Practice Address - Country:US
Practice Address - Phone:865-545-8905
Practice Address - Fax:865-545-8909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN473333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2133200OtherPK