Organization · Type 2 NPI
East Tennessee State University
Federally Qualified Health Center (FQHC) · Johnson City, TN
NPI number
1982905576
Active
Practice location
1134-1136 E. Main Street
Johnson City, TN 37601
Fax (423) 929-2930
Mailing address
365 Stout Drive Box 70403
Johnson City, TN 37614-1703
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Federally Qualified Health Center (FQHC) Primary | 261QF0400X | None listed |
Federally Qualified Health Center (FQHC): Definition to come...
Other federally qualified health center (fqhc) providers in Johnson City
About NPI 1982905576
East Tennessee State University's National Provider Identifier is 1982905576, issued on Nov 12, 2010. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Johnson City, TN. The record was last updated on Jul 21, 2022.