Provider Demographics
NPI:1972147437
Name:MOUNTAIN VIEW MEDICAL CENTER, LLC
Entity type:Organization
Organization Name:MOUNTAIN VIEW MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCELYEA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:865-585-5037
Mailing Address - Street 1:1700 PINEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-4365
Mailing Address - Country:US
Mailing Address - Phone:423-579-0101
Mailing Address - Fax:
Practice Address - Street 1:1700 PINEBROOK DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-4365
Practice Address - Country:US
Practice Address - Phone:423-579-0101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-29
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty