National Provider Identifier Database

MOUNTAIN EMPIRE SURGERY CENTER LP
Ambulatory Surgical


Contact Information

MOUNTAIN EMPIRE SURGERY CENTER LP
601 MED TECH PKWY
JOHNSON CITY, TN37604
Phone: 423-610-1020
Fax: 423-610-1021
Website:
Specialty Taxonomy Code
* Ambulatory Surgical 261QA1903X

* Indicates primary specialty

NPI Profile & details for MOUNTAIN EMPIRE SURGERY CENTER LP

NPI Number 1760486369
Legal business name
LBN
MOUNTAIN EMPIRE SURGERY CENTER LP
Authorized official KRISTEN OCONNOR - (AUTHORIZED OFFICIAL)
Entity Organization
Organization subpart No
Enumeration date 06/10/2005
Last updated 10/14/2024 - More than a year ago
Sole proprietor1 Not specified
Identifiers
  • TN License #: 0000000120
  • TN Medicaid: 3281998
  • TN Other: 3150816 BLUE CROSS BLUE SHIELD
  • TN Other: 490004752 MEDICARE RAILROAD

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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