Provider Demographics
NPI:1467784348
Name:VOLUNTEER STATE HEALTH PLAN
Entity Type:Organization
Organization Name:VOLUNTEER STATE HEALTH PLAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-535-7767
Mailing Address - Street 1:1 CAMERON HILL CIR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402-9815
Mailing Address - Country:US
Mailing Address - Phone:423-535-5600
Mailing Address - Fax:
Practice Address - Street 1:1 CAMERON HILL CIR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-9815
Practice Address - Country:US
Practice Address - Phone:423-535-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLUECROSS BLUESHIELD OF TENNESSEE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN302R00000X302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization