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Contact Information

STATE OF TENNESSEE
1021 SPRING ST
DOVER, TN37058-3302
 Phone: 931-232-5329
 Fax: 931-232-7247
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Public Health or Welfare

251K00000X 60 Public Health or Welfare Agency
 

Federally Qualified Health Center (FQHC)

261QF0400X B4[14] Federally Qualified Health Center
Indicates primary specialty

NPI Profile & details for STATE OF TENNESSEE

NPI Number 1083767883
LBN Legal business name STATE OF TENNESSEE
Authorized official ANNETTE HALEY - (REGIONAL DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 01/18/2007
Last updated 08/28/2012 - About 14 years ago
Identifiers
TN Medicaid 4448019
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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