Provider Demographics
NPI:1679672562
Name:RURAL HEALTH SERVICES CONSORTIUM OF UPPER EAST TENNESSEE INC
Entity Type:Organization
Organization Name:RURAL HEALTH SERVICES CONSORTIUM OF UPPER EAST TENNESSEE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:W
Authorized Official - Last Name:BUCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-272-9163
Mailing Address - Street 1:PO BOX 850
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37857-0850
Mailing Address - Country:US
Mailing Address - Phone:423-272-9163
Mailing Address - Fax:423-921-6920
Practice Address - Street 1:4966 HIGHWAY 11-W
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37857-0850
Practice Address - Country:US
Practice Address - Phone:423-272-9163
Practice Address - Fax:423-921-6920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3703865Medicaid
CI2519OtherRAILROAD MEDICARE
441814Medicare PIN
3703865Medicare PIN