Church Street Pavilion

LBN: Frontier Health
Church Street Pavilion is an health care organization with primary practice located at 616 E Church St Suite A, Greeneville TN 37745-5084. The organization recently has 4 registered licenses in different health care specialties including Agencies / Case Management, Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder. Agencies / Community/Behavioral Health is the primary health care specialty. Frontier Health can be contacted via phone (423) 639-3213, or through Hammonds, Kristie via phone (423) 467-3600.

Contact Information

Primary practice address
616 E Church St Suite A Greeneville TN 37745-5084
Phone: (423) 639-3213
Fax: (423) 639-4692
Website:
Map and Directions
Authorized official contact:
Name: Hammonds, Kristie
Phone: (423) 467-3600

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X L-214-076-1407 Tennessee
Agencies / Community/Behavioral Health 251S00000X L214-076-1407 Tennessee
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X L-214-076-1407 Tennessee
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X 369 Tennessee

Profile Details

NPI number 1881756161
LBN Legal business name Frontier Health
DBA Doing business as Church Street Pavilion
Authorized official Hammonds, Kristie
Entity Organization
Organization subpart 1 No
Enumeration date Dec 14th, 2006
Last updated Jan 10th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881756161 NPPES
Virginia MEDICAID 49-4919-6
Virginia MEDICAID SAME AS MEDICARE #S

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