Provider Demographics
NPI:1043418742
Name:SENTEF MEDICAL CENTER
Entity type:Organization
Organization Name:SENTEF MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PLASTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:237-604-6304
Mailing Address - Street 1:9380 BRADMORE LN STE 104
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-4447
Mailing Address - Country:US
Mailing Address - Phone:423-760-4630
Mailing Address - Fax:423-760-4631
Practice Address - Street 1:9380 BRADMORE LN STE 104
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-4447
Practice Address - Country:US
Practice Address - Phone:423-760-4630
Practice Address - Fax:423-760-4631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3855491Medicare ID - Type Unspecified