Provider Demographics
NPI:1649266974
Name:BLOUNT MEMORIAL HOSPITAL, INC.
Entity type:Organization
Organization Name:BLOUNT MEMORIAL HOSPITAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:NARAMORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-977-5533
Mailing Address - Street 1:1095 E LAMAR ALEXANDER PKWY
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37804-5134
Mailing Address - Country:US
Mailing Address - Phone:865-981-2160
Mailing Address - Fax:865-977-4616
Practice Address - Street 1:1095 E LAMAR ALEXANDER PKWY
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37804-5134
Practice Address - Country:US
Practice Address - Phone:865-981-2160
Practice Address - Fax:865-977-4616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-22
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN447469251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN148002OtherBLUE CROSS BLUE SHIELD
TN148002OtherBLUE CROSS BLUE SHIELD