Provider Demographics
NPI:1184870883
Name:COUNTY OF HAMILTON
Entity type:Organization
Organization Name:COUNTY OF HAMILTON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-209-8000
Mailing Address - Street 1:5520 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-8131
Mailing Address - Country:US
Mailing Address - Phone:423-238-4269
Mailing Address - Fax:
Practice Address - Street 1:5520 HIGH ST
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-8131
Practice Address - Country:US
Practice Address - Phone:423-209-8000
Practice Address - Fax:423-209-8001
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF HAMILTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-13
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3911619Medicare PIN
TN3371116Medicare PIN