MEDICARE: HILLSIDE HOSPITAL LLC

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	276400000X	Substance Use Disorder Rehabilitation Hospital Unit
2	282NR1301X	Rural Acute Care Hospital	0000000052	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	440020	OTHER	TN	STERLING OPTIONS
3	1000125	OTHER	TN	BCBS
4	010081	OTHER	AL	BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841388519
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HILLSIDE HOSPITAL LLC

Provider Business Mailing Address
First Line	:	330 SEVEN SPRINGS WAY
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-4536
Country	:	US
Telephone Number	:	615-920-7000
Fax Number	:	615-920-8913

Provider Business Practice Location Address
First Line	:	1265 E COLLEGE ST
Second Line	:
City	:	PULASKI
State	:	TN
Zip	:	38478-4541
Country	:	US
Telephone Number	:	931-363-7531
Fax Number	:	931-363-9303

Authorized Official
Title or Position	:	ASSISTANT SECRETARY
Name	:	TERRANCE DILLON
Credential	:
Telephone Number	:	502-596-7220

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	04/26/2022

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