Provider Information for 1063737732
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CONTINUUMRX OF EAST TENNESSEE, LLC
Organization Subpart: NO
NPI: 1063737732
Last Updated: 2013-10-11
Certification Date:
Certification Date:
Details
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NPI | 1063737732 | ||||||||||||||||||||||||||||||||
Enumeration Date | 2010-04-06 | ||||||||||||||||||||||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||||||||||||||||||||||
Status | Active | ||||||||||||||||||||||||||||||||
Authorized Official Information | Name: Mr. TOD C. HANSON Title: VP of Operations Phone: 2059689500 | ||||||||||||||||||||||||||||||||
Mailing Address | PO BOX 830525 DEPT R 2 BIRMINGHAM, AL 35283-0525 United States Phone: 205-968-9500 | Fax:205-991-1501 | ||||||||||||||||||||||||||||||||
Primary Practice Address | 2210 SUTHERLAND AVE SUITE 112 KNOXVILLE, TN 37919-2337 United States Phone: 800-665-2850 | Fax:865-934-0249 | ||||||||||||||||||||||||||||||||
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