NPI 1720468200
Mountain States Health Alliance
Practice location
- Address
- 2204 Pavilion Dr Suite 115, Kingsport, TN 37660-4657
- Phone
- (423) 857-6777
- Fax
- (423) 857-6788
- Mailing address
- 311 Princeton Rd STE 1, Johnson City, TN 37601-2026
Authorised official
- Name
- Gregory Lee Wilgocki
- Title
- Corp Director Reimbursement
- Phone
- (423) 431-5794
Registered specialties
General Acute Care Hospital
Primary
Registry record
- NPI
- 1720468200
- Entity type
- Organization
- NPI issued
- 1 Jun 2015
- Record last updated
- 11 Dec 2017
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.