Provider Demographics
NPI:1841846136
Name:STATE OF FRANKLIN HEALTHCARE ASSOCIATES PLLC
Entity type:Organization
Organization Name:STATE OF FRANKLIN HEALTHCARE ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF QUALITY
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-794-2450
Mailing Address - Street 1:PO BOX 3889
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37602-3889
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:215 E SPRINGBROOK DR
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-1761
Practice Address - Country:US
Practice Address - Phone:423-794-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STATE OF FRANKLIN HEALTHCARE ASSOCIATES PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-13
Last Update Date:2020-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory