Provider Demographics
NPI:1780837435
Name:ROANE COUNTY MEDICAL CENTER
Entity type:Organization
Organization Name:ROANE COUNTY MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF THE BUSINESS OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:D
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-316-2008
Mailing Address - Street 1:8045 ROANE MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-8333
Mailing Address - Country:US
Mailing Address - Phone:865-316-1000
Mailing Address - Fax:865-316-3700
Practice Address - Street 1:8045 ROANE MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748-8333
Practice Address - Country:US
Practice Address - Phone:865-316-1000
Practice Address - Fax:865-316-3700
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROANE MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000098275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN44U031Medicare Oscar/Certification