Provider Demographics
NPI:1386673283
Name:JAMES H. QUILLEN VA MEDICAL CENTER
Entity Type:Organization
Organization Name:JAMES H. QUILLEN VA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ER DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HARBER
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-926-1171
Mailing Address - Street 1:CORNER OF SIDNEY AND LAMONT
Mailing Address - Street 2:(JOHNSON CITY)
Mailing Address - City:MOUTAIN HOME
Mailing Address - State:TN
Mailing Address - Zip Code:37684
Mailing Address - Country:US
Mailing Address - Phone:423-926-1171
Mailing Address - Fax:423-979-3558
Practice Address - Street 1:JAMES H. QUILLEN/VAMC
Practice Address - Street 2:CORNER OF SIDNEY AND LAMONT (JOHNSON CITY)
Practice Address - City:MOUTAIN HOME
Practice Address - State:TN
Practice Address - Zip Code:37684
Practice Address - Country:US
Practice Address - Phone:423-926-1171
Practice Address - Fax:423-979-3558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN029967282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access