Healthcare Provider Details

I. General information

NPI: 1568537348
Provider Name (Legal Business Name): CUMBERLAND RIVER HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 12/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 OLD JEFFERSON ST
CELINA TN
38551-4040
US

IV. Provider business mailing address

100 OLD JEFFERSON ST PO BOX 427
CELINA TN
38551-4040
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number15
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number15
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number15
License Number StateTN
# 5
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: PATRICIA LYNNE STRONG
Title or Position: CAO
Credential:
Phone: 931-243-3581