| Details | Last Recertification Date | Update | Recertification | 2/6/2024 8:33:40 AM | 2/14/2025 9:43:10 AM | 2/14/2025 9:43 AM |
| Details | Last Recertification Date | Update | Recertification | 2/3/2023 9:07:11 AM | 2/6/2024 8:33:40 AM | 2/6/2024 8:33 AM |
| Addresses | Main Address | Update | Recertification |
2700 Main St
Sneedville, TN 37869-3041 |
2700 Main St
Sneedville, TN 37869 | 2/3/2023 9:07 AM |
| Details | Last Recertification Date | Update | Recertification | 2/25/2022 10:39:03 AM | 2/3/2023 9:07:11 AM | 2/3/2023 9:07 AM |
| Contacts | Authorizing Official | Update | AO Change Request | Tolan, Silas
Executive Director
ETSU
4234394051 | Queen, Melissa
Business Director
East Tennessee State University
4234394076 | 1/31/2023 11:56 AM |
| Addresses | Billing Address | Update | Recertification | EAST TENNESSEE STATE UNIVERSITY - COLLEGE OF NURSING - ADMINISTRATIVE OFFICE
PO BOX 70403
SNEEDVILLE, TN 37869 | EAST TENNESSEE STATE UNIVERSITY COLLEGE OF NURSING
400 JL Seehorn Road
Johnson City, TN 37614 | 2/25/2022 10:39 AM |
| Details | Last Recertification Date | Update | Recertification | 2/28/2021 11:55:09 PM | 2/25/2022 10:39:03 AM | 2/25/2022 10:39 AM |
| Details | Last Recertification Date | Update | Recertification | 2/7/2020 11:16:58 AM | 2/28/2021 11:55:09 PM | 2/28/2021 11:55 PM |
| Details | Last Recertification Date | Update | Recertification | 2/26/2019 5:02:03 PM | 2/7/2020 11:16:58 AM | 2/7/2020 11:16 AM |
| Details | Last Recertification Date | Update | Recertification | 3/1/2018 10:42:54 AM | 2/26/2019 5:02:03 PM | 2/26/2019 5:02 PM |
| Contacts | Primary Contact | Update | Recertification | Tolan, Silas
Executive Director
ETSU
4234394051 | Erb, Andrea
Pharmacist
East Tennessee State University
4239262500 | 3/1/2018 10:42 AM |
| Details | Last Recertification Date | Update | Recertification | 1/25/2017 12:00:00 AM | 3/1/2018 10:42:54 AM | 3/1/2018 10:42 AM |
| Contacts | Authorizing Official | Update | | Tolan, Silas
Executive Director
4234394051 | Tolan, Silas
Executive Director
ETSU
4234394051 | 1/15/2018 6:09 PM |
| Contacts | Primary Contact | Update | | Tolan, Silas
Executive Director
4234394051 | Tolan, Silas
Executive Director
ETSU
4234394051 | 1/15/2018 6:09 PM |
| Contacts | Authorizing Official | Update | | Melke, Richard C.
Executive Director
4234394051 | Tolan, Silas
Executive Director
4234394051 | 6/22/2017 3:12 PM |
| Contacts | Primary Contact | Update | | Melke, Richard C.
Executive Director
4234394051 | Tolan, Silas
Executive Director
4234394051 | 6/22/2017 3:12 PM |
| Addresses | Main Address | Insert | | |
2700 Main St
Sneedville, TN 37869-3041 | 1/25/2017 4:52 PM |
| Details | Last Recertification Date | Update | | 2/12/2016 12:00:00 AM | 1/25/2017 12:00:00 AM | 1/25/2017 4:52 PM |
| Details | Last Recertification Date | Update | | 2/10/2015 12:00:00 AM | 2/12/2016 12:00:00 AM | 2/12/2016 9:27 AM |
| Details | Last Recertification Date | Update | | 3/20/2014 12:00:00 AM | 2/10/2015 12:00:00 AM | 2/10/2015 3:44 PM |
| Details | Last Recertification Date | Update | | 4/1/2013 12:00:00 AM | 3/20/2014 12:00:00 AM | 3/20/2014 8:51 AM |
| Details | Entity Name | Update | | EAST TENNESSEE STATE UNIVERSITY - COLLEGE OF NURSING | EAST TENNESSEE STATE UNIVERSITY | 3/20/2014 8:51 AM |
| Details | Entity Subname | Update | | HANCOCK COUNTY SCHOOL BASED HEALTH CENTERS - MIDDLE/HIGH SCHOOL SITE | HANCOCK CTY SBHC/HIGH SCHOOL | 3/20/2014 8:51 AM |
| Contacts | Authorizing Official | Update | | ANDERSON, MARY KAY
CEO
4234394051 | Melke, Richard C.
Executive Director
4234394051 | 2/12/2014 11:57 AM |
| Contacts | Primary Contact | Update | | SCHALLER-AYERS, JENNIFER
CEO
4234394064 | Melke, Richard C.
Executive Director
4234394051 | 2/12/2014 11:57 AM |
| Details | Last Recertification Date | Update | | | 4/1/2013 12:00:00 AM | 2/25/2013 10:14 AM |
| Contacts | Authorizing Official | Insert | | | ANDERSON, MARY KAY
CEO
4234394051 | 4/25/2006 2:59 PM |
| Addresses | Billing Address | Insert | | | EAST TENNESSEE STATE UNIVERSITY - COLLEGE OF NURSING - ADMINISTRATIVE OFFICE
PO BOX 70403
SNEEDVILLE, TN 37869 | 8/12/2005 9:36 AM |
| Contacts | Primary Contact | Insert | | | SCHALLER-AYERS, JENNIFER
CEO
4234394064 | 8/12/2005 9:36 AM |
| Details | Last Recertification Date | Insert | | | | 8/12/2005 9:36 AM |
| Details | Grant Number | Insert | | | H80CS00840 | 8/12/2005 9:36 AM |
| Details | 340B ID | Insert | | | CH041349B | 8/12/2005 9:36 AM |
| Details | Is Authorizing Official EHB Data | Insert | | | | 8/12/2005 9:36 AM |
| Dates | Last Date That 340B Drugs Purchased | Insert | | | | 8/12/2005 9:36 AM |
| Details | Medicare Provider Number | Insert | | | | 8/12/2005 9:36 AM |
| Details | Entity Name | Insert | | | EAST TENNESSEE STATE UNIVERSITY - COLLEGE OF NURSING | 8/12/2005 9:36 AM |
| Details | Program Code | Insert | | | CH | 8/12/2005 9:36 AM |
| Details | Entity Subname | Insert | | | HANCOCK COUNTY SCHOOL BASED HEALTH CENTERS - MIDDLE/HIGH SCHOOL SITE | 8/12/2005 9:36 AM |
| Dates | Participating Approval Date | Insert | | | 12/16/2004 12:00:00 AM | 8/12/2005 9:36 AM |
| Details | State | Insert | | | Active | 8/12/2005 9:36 AM |
| Dates | Registration Date | Insert | | | 1/1/2005 12:00:00 AM | 8/12/2005 9:36 AM |
| Dates | Signed By Date | Insert | | | | 8/12/2005 9:36 AM |
| Dates | Start Date | Insert | | | 1/1/2005 12:00:00 AM | 8/12/2005 9:36 AM |
| Terminations | Termination Comments | Insert | | | | 8/12/2005 9:36 AM |
| Terminations | Termination Date | Insert | | | | 8/12/2005 9:36 AM |
| Terminations | Termination Effective Date | Insert | | | | 8/12/2005 9:36 AM |
| Terminations | Termination Reason | Insert | | | | 8/12/2005 9:36 AM |
| Details | Comments Public | Insert | | | NEW SITE 01/01/2005 | 8/12/2005 9:36 AM |