Provider Demographics
NPI:1851444830
Name:STATE OF TENNESSEE
Entity Type:Organization
Organization Name:STATE OF TENNESSEE
Other - Org Name:GREENE CO HEALTH DEPT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGLISH
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:423-798-1749
Mailing Address - Street 1:810 WEST CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-3285
Mailing Address - Country:US
Mailing Address - Phone:423-798-1749
Mailing Address - Fax:423-798-1755
Practice Address - Street 1:810 WEST CHURCH ST
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-3285
Practice Address - Country:US
Practice Address - Phone:423-798-1749
Practice Address - Fax:423-798-1755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-21
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3911480Medicare PIN