Provider Demographics
NPI:1437961000
Name:INTERSTATE HEALTH SYSTEMS, INC
Entity type:Organization
Organization Name:INTERSTATE HEALTH SYSTEMS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BETHANY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-767-0142
Mailing Address - Street 1:7200 STRAWBERRY PLAINS PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37914-9589
Mailing Address - Country:US
Mailing Address - Phone:865-240-3038
Mailing Address - Fax:
Practice Address - Street 1:7200 STRAWBERRY PLAINS PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37914-9589
Practice Address - Country:US
Practice Address - Phone:865-240-3038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-22
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health