OrganizationActive
Etlog Management Service
NPI 1932750189 · Health Service Clinic/Center · Kingsport, TN
Provider details
- NPI number
- 1932750189
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Etlog Management Service
- Organization subpart
- Yes
- Authorized official
- Yaw Otchere-Boateng, Ceo(423) 677-7040
Specialties & taxonomies
Ambulatory Health Care Facilities
- VA Clinic/Center261QV0200X
Ambulatory Health Care Facilities
- Clinical Medical Laboratory291U00000X
Laboratories
- Case Management Agency251B00000X
Agencies
- Nursing Care Agency251J00000X
Agencies
- Primary Care Clinic/Center261QP2300X
Ambulatory Health Care Facilities
- Mobile Radiology Clinic/Center261QR0208X
Ambulatory Health Care Facilities
Practice location
1005 Carrington Ct
Kingsport, TN 37660-5694
Phone: (423) 677-7040
Approximate (ZIP-level) locationGet directions
Mailing address
1005 Carrington Ct
Kingsport, TN 37660-5694
Other names (DBA / former)
- Doing business as
- Hhomecare
Registry dates
- Enumerated
- 2019-09-27
- Last updated
- 2020-09-08
- Certified
- 2020-09-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.