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Contact Information

MOUNTAIN STATES HEALTH ALLIANCE
1901 S SHADY ST
MOUNTAIN CITY, TN37683-2021
 Phone: 423-727-1100
 Fax: 423-727-1105
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Rural Health

261QR1300X B4[14] Rural Health Clinic
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for MOUNTAIN STATES HEALTH ALLIANCE

NPI # 1205846508
LBN Legal business name MOUNTAIN STATES HEALTH ALLIANCE
Authorized official DWAYNE TAYLOR - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 08/09/2006
Last updated 08/12/2024 - More than a year ago
Identifiers
TN Medicaid 3278673
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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