1710905609 NPI number — TROUSDALE MEDICAL CENTER, INC.

Table of content: (NPI 1710905609)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710905609 NPI number — TROUSDALE MEDICAL CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TROUSDALE MEDICAL CENTER, INC.
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:
1710905609
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/24/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
555 HARTSVILLE PIKE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GALLATIN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37066-2400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-328-6695
Provider Business Mailing Address Fax Number:
615-328-6698

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 CHURCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARTSVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37074-1744
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-374-2221
Provider Business Practice Location Address Fax Number:
615-374-2936
Provider Enumeration Date:
07/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WILHOITE
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
615-328-6695

Provider Taxonomy Codes

  • Taxonomy code: 282NC0060X , with the licence number:  0000000118 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0160074 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0441301 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 166551100 . This is a "US DEPT OF LABOR" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 309040 . This is a "CSA MID & UPPER CUMBERLND" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 50003046 . This is a "KY MEDICAID PASSPORT HLTH" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 0410430 . This is a "HEALTH SPRINGS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 5345219 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0545006 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5000403 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3143773 . This is a "TENNCARE SELECT" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 320051 . This is a "MEDICARE ID-TYPE UNSPECIFIED" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: A3707401 . This is a "TENNCARE AMERI CHOICE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 3143773 . This is a "BLUE CROSS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 3147773 . This is a "TENNCARE BLUE CROSS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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