1801814629 NPI number — FRANK T RUTHERFORD MEMORIAL HOSPITAL, INC

Table of content: (NPI 1801814629)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801814629 NPI number — FRANK T RUTHERFORD MEMORIAL HOSPITAL, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRANK T RUTHERFORD MEMORIAL HOSPITAL, 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:
6
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:
1801814629
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:
130 LEBANON HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARTHAGE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37030-2955
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-735-9815
Provider Business Practice Location Address Fax Number:
615-735-3062
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:  0000000129 , 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: 1000177 . This is a "BLUE CROSS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 1000177 . This is a "TENNCARE SELECT" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 1000177 . This is a "TENNCARE BLUE CROSS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 0441307 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01600568 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3282272 . This is a "MEDICARE ID-TYPE UNSPECIFIED" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 5000098 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 165461900 . This is a "US DEPT OF LABOR WC" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: A3703300 . This is a "TENNCARE AMERI CHOICE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com