Organization Name:  MOUNTAIN EMPIRE SURGERY CENTER LP


Practice Location:
601 MED TECH PKWY  JOHNSON CITY, TN 37604 US
Tel: 423-610-1020  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	261QA1903X	Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical	TN	0000000120

Other Provider Identifiers:

Issuer	Number	State	Type
	3281998	TN	05
BLUE CROSS BLUE SHIELD	3150816	TN	01
MEDICARE RAILROAD	490004752	TN	01

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin