1437094778 NPI number — MAURY REGIONAL HOSPITAL

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437094778 NPI number — MAURY REGIONAL HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MAURY REGIONAL HOSPITAL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437094778
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/26/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
416 S TYLER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMARILLO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79101-2346
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-242-7782
Provider Business Mailing Address Fax Number:
931-994-0140

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3316 HIGHWAY 43 STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ETHRIDGE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38456-2136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
931-362-6919
Provider Business Practice Location Address Fax Number:
931-994-0140
Provider Enumeration Date:
04/22/2026

Additional Information

Authorized Official

Authorized Official Last Name:
WRIGHT
Authorized Official First Name:
JOEL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT, PHARMACY SERVICES
Authorized Official Telephone Number:
806-242-7782

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: Q116651 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




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