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Contact Information

EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER INC.
1705 ROANE STATE HWY
HARRIMAN, TN37748-8306
 Phone: 865-316-5001
 Fax: 865-376-3713
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Family

363LF0000X 50 Nurse Practitioner
 

Pediatrics

363LP0200X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER INC.

NPI Number 1669104196
LBN Legal business name EAST TENNESSEE CHILDREN'S HOSPITAL PRIMARY CARE CENTER INC.
Authorized official ANDREW ROSENDAHL - (CHIEF FINANCIAL OFFICER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 06/24/2022
Last updated 01/14/2026 - About 5 months ago
Identifiers
TN Medicaid Q074655
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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