Provider Demographics
NPI:1720099419
Name:MORGAN COUNTY HEALTH COUNCIL INC
Entity Type:Organization
Organization Name:MORGAN COUNTY HEALTH COUNCIL INC
Other - Org Name:MORGAN COUNTY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-346-6221
Mailing Address - Street 1:224 OLD MILL ROAD
Mailing Address - Street 2:P.O. BOX 408
Mailing Address - City:WARTBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37887
Mailing Address - Country:US
Mailing Address - Phone:423-346-6221
Mailing Address - Fax:423-346-5565
Practice Address - Street 1:224 OLD MILL ROAD
Practice Address - Street 2:
Practice Address - City:WARTBURG
Practice Address - State:TN
Practice Address - Zip Code:37887
Practice Address - Country:US
Practice Address - Phone:423-346-6221
Practice Address - Fax:423-346-5565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3375992OtherCIGNA MEDICARE
TN3375992OtherCIGNA MEDICARE