Organization Name:  THE ENDOSCOPY CENTER OF BRISTOL


Practice Location:
235 MEDICAL PARK BLVD  BRISTOL, TN 37620 US
Tel: 423-246-6777  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	0000000114

Other Provider Identifiers:

Issuer	Number	State	Type
	007603819	VA	05
	7603819	KY	05
PHP TENNCARE	100036168	TN	01
	3288515	TN	05
BCBS OF TN	004001475	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