Provider Demographics
NPI:1982873600
Name:MORRISTOWN HAMBLEN HOSPITAL
Entity Type:Organization
Organization Name:MORRISTOWN HAMBLEN HOSPITAL
Other - Org Name:TENNESSEE HEART & VASCULAR SPECIALIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REVENUE CYCLE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:RIESEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-522-4390
Mailing Address - Street 1:PO BOX 1182
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37816-1182
Mailing Address - Country:US
Mailing Address - Phone:423-522-4326
Mailing Address - Fax:423-585-3399
Practice Address - Street 1:908 W 4TH NORTH ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3894
Practice Address - Country:US
Practice Address - Phone:423-522-4326
Practice Address - Fax:423-585-3399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN32842161Medicare PIN