Provider Demographics
NPI:1477529550
Name:UNICOI COUNTY MEMORIAL HOSPITAL INC.
Entity Type:Organization
Organization Name:UNICOI COUNTY MEMORIAL HOSPITAL INC.
Other - Org Name:UNICOI COUNTY HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF HOME HEALTH
Authorized Official - Prefix:MR
Authorized Official - First Name:TED
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:423-743-3141
Mailing Address - Street 1:100 GREENWAY CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ERWIN
Mailing Address - State:TN
Mailing Address - Zip Code:37650
Mailing Address - Country:US
Mailing Address - Phone:423-743-1278
Mailing Address - Fax:423-735-7686
Practice Address - Street 1:100 GREENWAY CIRCLE
Practice Address - Street 2:
Practice Address - City:ERWIN
Practice Address - State:TN
Practice Address - Zip Code:37650
Practice Address - Country:US
Practice Address - Phone:423-743-1278
Practice Address - Fax:423-735-7686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-27
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000355251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN447554Medicare ID - Type Unspecified