Healthcare Provider Details

I. General information

NPI: 1558676445
Provider Name (Legal Business Name): CUMBERLAND RIVER HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2010
Last Update Date: 11/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 DOCTORS DR
CELINA TN
38551-4040
US

IV. Provider business mailing address

100 OLD JEFFERSON ST
CELINA TN
38551-4040
US

V. Phone/Fax

Practice location:
  • Phone: 931-243-3860
  • Fax: 931-243-4607
Mailing address:
  • Phone: 931-243-3581
  • Fax: 931-243-5219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA L STRONG
Title or Position: CFO
Credential:
Phone: 931-243-3581