Provider Demographics
NPI:1326125428
Name:BLOUNT MEMORIAL HOSPITAL, INC.
Entity Type:Organization
Organization Name:BLOUNT MEMORIAL HOSPITAL, INC.
Other - Org Name:NEW HOPE CHILDREN'S ADVOCACY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR BMH MSO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HOBBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-273-1750
Mailing Address - Street 1:701 MORGANTON SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37801-4796
Mailing Address - Country:US
Mailing Address - Phone:865-273-1752
Mailing Address - Fax:865-273-1755
Practice Address - Street 1:212 CATES ST
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-4902
Practice Address - Country:US
Practice Address - Phone:865-981-2000
Practice Address - Fax:865-981-5422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNI20962Medicare UPIN
TNG55899Medicare UPIN