MEDICARE: MAURY REGIONAL HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	275N00000X	Medicare Defined Swing Bed Hospital Unit	0000000125	TN
2	3336I0012X	Institutional Pharmacy	1866	TN
3	282N00000X	General Acute Care Hospital	0000000125	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2138156	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811927544
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAURY REGIONAL HOSPITAL

Provider Business Mailing Address
First Line	:	PO BOX 100054
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30348-0054
Country	:	US
Telephone Number	:	931-381-1111
Fax Number	:	931-540-4294

Provider Business Practice Location Address
First Line	:	103 JV MANGUBAT DR
Second Line	:
City	:	WAYNESBORO
State	:	TN
Zip	:	38485-2440
Country	:	US
Telephone Number	:	931-722-5411
Fax Number	:	931-722-6407

Authorized Official
Title or Position	:	VP FINANCE/IT
Name	:	GREGORY A WHITLOCK
Credential	:
Telephone Number	:	931-540-4212

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	06/03/2025

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Directions to “MAURY REGIONAL HOSPITAL ” Practice Location

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