Provider Demographics
NPI:1760651301
Name:SCOTT COUNTY HMA LLC
Entity type:Organization
Organization Name:SCOTT COUNTY HMA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:239-552-3490
Mailing Address - Street 1:18797 ALBERTA ST
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:TN
Mailing Address - Zip Code:37841-2127
Mailing Address - Country:US
Mailing Address - Phone:423-569-8521
Mailing Address - Fax:423-569-2857
Practice Address - Street 1:18797 ALBERTA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-2127
Practice Address - Country:US
Practice Address - Phone:423-286-5300
Practice Address - Fax:423-286-5661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208M00000X
TN0000000101282N00000X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0441317Medicaid
KY7100049530Medicaid
TN0441317Medicaid
TN441317Medicare Oscar/Certification
440052Medicare Oscar/Certification