Mountain States Health Alliance
NPI #1053496901 in Johnson City, Tennessee
Provider Information
- NPI Number
- 1053496901
- Entity Type
- Organization
- Organization Name
- Mountain States Health Alliance
- Primary Specialty
- Home Infusion
- Enumeration Date
- Oct 26, 2006
- Last Updated
- Mar 29, 2018
Practice Location
- Address
- 101 MED TECH PKWY
- Address 2
- SUITE 100
- City
- Johnson City
- State
- Tennessee
- ZIP Code
- 37604-4007
- Phone
- (423) 431-4601
Authorized Official
- Name
- MARY LYNN KRUTAK
- Title
- EVP/CFO
- Phone
- (423) 302-3423
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
| Home Infusion |
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