Provider Demographics
NPI:1346236494
Name:BLOUNT MEMORIAL HOSPITAL, INC.
Entity Type:Organization
Organization Name:BLOUNT MEMORIAL HOSPITAL, INC.
Other - Org Name:BLOUNT MEMORIAL HOSPITAL HOSPICE
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 1:907 EAST LAMAR ALEXANDER PARKWAY
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37804
Mailing Address - Country:US
Mailing Address - Phone:865-983-7211
Mailing Address - Fax:865-981-2333
Practice Address - Street 1:1095 EAST LAMAR ALEXANDER PARKWAY
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37804
Practice Address - Country:US
Practice Address - Phone:865-977-5702
Practice Address - Fax:865-977-4787
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLOUNT MEMORIAL HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-23
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN441526251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN156907OtherBLUE CROSS BLUE SHIELD
TN0441526Medicaid
TN0441526Medicaid