Provider Demographics
NPI:1164498994
Name:BLOUNT MEMORIAL HOSPITAL, INC.
Entity Type:Organization
Organization Name:BLOUNT MEMORIAL HOSPITAL, INC.
Other - Org Name:BLOUNT MEMORIAL TRANSITIONAL CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:NARAMORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-977-5533
Mailing Address - Street 1:2320 E LAMAR ALEXANDER PKWY
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37804-5316
Mailing Address - Country:US
Mailing Address - Phone:865-273-8300
Mailing Address - Fax:865-273-8367
Practice Address - Street 1:2320 E LAMAR ALEXANDER PKWY
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37804-5316
Practice Address - Country:US
Practice Address - Phone:865-273-8300
Practice Address - Fax:865-273-8367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-23
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000365314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3080218OtherBLUE CROSS PROVIDER #
TN3080218OtherBLUE CROSS PROVIDER #