Mountain States Health Alliance
Clinic/Center, Radiology in Johnson City, TN. Organization (NPI-2).
NPI number1487983003
StatusActive
Last updated in NPPESDec 10, 2009
Details
- NPI
- 1487983003
- Entity type
- Organization (NPI-2)
- Legal business name
- Mountain States Health Alliance
- Organization subpart
- No
- Enumeration date
- Dec 10, 2009
- Last updated
- Dec 10, 2009
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0200X | Clinic/Center, Radiology | MDX0000005568 | TN | Yes |
Practice location
301 Med Tech PkwySuite 100
Johnson City, TN 37604-2364
Phone 423-610-6226 · Fax 423-283-7340
Mailing address
301 Med Tech PkwySuite 100
Johnson City, TN 37604-2364
Phone 423-610-6226 · Fax 423-283-7340
Authorized official
Linda Frazier
Director Of Diagnostic Imaging
4234316471
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