Provider Demographics
NPI:1871530832
Name:CENTRAL TENNESSEE HOSPITAL CORPORATION
Entity type:Organization
Organization Name:CENTRAL TENNESSEE HOSPITAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CLARENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-326-2530
Mailing Address - Street 1:111 HIGHWAY 70 E
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2080
Mailing Address - Country:US
Mailing Address - Phone:615-446-0446
Mailing Address - Fax:615-441-2514
Practice Address - Street 1:111 HIGHWAY 70 E
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2080
Practice Address - Country:US
Practice Address - Phone:615-446-0446
Practice Address - Fax:615-441-2514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY01600006Medicaid
TX149780201Medicaid
MO15250400Medicaid
OH2484217Medicaid
5000037OtherUNITED HEALTHCARE
GA000934513XMedicaid
TN0440046Medicaid
MI30-4694062Medicaid
CT003127893Medicaid
AR152295150Medicaid
WI82500100Medicaid
VA010017041Medicaid
0410153OtherHEALTHSPRING
LA1707015Medicaid
OK200027800AMedicaid
CO72836245Medicaid
NC4400046Medicaid
NJ0054747Medicaid
FL910790800Medicaid
ALHOR0046NMedicaid
CAXHSP33762Medicaid
IL=========001Medicaid
FL910790800Medicaid