NPIMap

Organization Active NPI

Unicoi County Memorial Hospital Inc

  • Home Infusion Therapy Pharmacy
  • Erwin, TN
National Provider Identifier
1861538308
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion Therapy PharmacyTaxonomy code 3336H0001X
License
1374 Issued in TN
Legal business name
UNICOI COUNTY MEMORIAL HOSPITAL INC
Practice address
100 Greenway Cir
Erwin, TN 37650-2177
Phone
(423) 743-1229
Fax
(423) 743-2816
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Billy Moore, DPH
Title
Dir Phcy SVCS
Phone
(423) 743-1272

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Therapy Pharmacy 3336H0001X 1374 TN Primary
Institutional Pharmacy 3336I0012X

Addresses

Primary practice location

100 Greenway Cir
Erwin, TN 37650-2177

Mailing address

100 Greenway Cir
Erwin, TN 37650-2177
Phone (423) 743-1229

Other identifiers 3

IdentifierTypeStateIssuer
4414087OtherNCPDP PROVIDER IDENTIFICATION NUMBER
0445077MedicaidTN
7440197MedicaidTN

Other names 1

  • UNICOI COUNTY MEMORIAL HOSPITAL Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Unicoi County Memorial H3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324339200000",
    "number": "1861538308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GREENWAY CIR",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376502177",
            "telephone_number": "423-743-1229",
            "fax_number": "423-743-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GREENWAY CIR",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376502177",
            "telephone_number": "423-743-1229",
            "fax_number": "423-743-2816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNICOI COUNTY MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2011-12-20",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "BILLY",
        "authorized_official_title_or_position": "DIR PHCY SVCS",
        "authorized_official_telephone_number": "423-743-1272",
        "authorized_official_credential": "DPH"
    },
    "taxonomies": [
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "TN",
            "license": "1374",
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4414087",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0445077",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7440197",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UNICOI COUNTY MEMORIAL HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Erwin, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.