National Provider Identifier Database

EAST TENNESSEE STATE UNIVERSITY
Federally Qualified Health Center (FQHC)

A Federally Qualified Health Center (FQHC) is a community-based organization that provides comprehensive primary care and preventive care, including health, oral, and mental health/substance abuse services to persons of all ages, regardless of their ability to pay or health insurance status.


Contact Information

EAST TENNESSEE STATE UNIVERSITY
2151 CENTURY LANE
JOHNSON CITY, TN37604
Phone: 423-926-2500
Fax: 423-926-5999
Website:
Specialty Taxonomy Code
* Federally Qualified Health Center (FQHC) 261QF0400X

* Indicates primary specialty

NPI Profile & details for EAST TENNESSEE STATE UNIVERSITY

NPI Number 1477660199
Legal business name
LBN
EAST TENNESSEE STATE UNIVERSITY
Authorized official BETTY KING - (SENIOR ASSOCIATE VICE PRESIDENT F&A)
Entity Organization
Organization subpart No
Enumeration date 08/25/2006
Last updated 07/21/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • TN Medicaid: 0441901

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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