Provider Demographics
NPI:1356317754
Name:MMS KNOXVILLE, INC
Entity Type:Organization
Organization Name:MMS KNOXVILLE, INC
Other - Org Name:MEDICAL EQUIPMENT DISTRIBUTORS OF TENNESSEE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-584-5501
Mailing Address - Street 1:357 RIVERSIDE DR
Mailing Address - Street 2:STE 120
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-8963
Mailing Address - Country:US
Mailing Address - Phone:651-790-1556
Mailing Address - Fax:615-790-6841
Practice Address - Street 1:5210 S MIDDLEBROOK PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37921-5972
Practice Address - Country:US
Practice Address - Phone:865-584-5501
Practice Address - Fax:865-584-5560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-24
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4522623332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1452105Medicaid
TN1452105Medicaid