Healthcare Provider Details

I. General information

NPI: 1720036841
Provider Name (Legal Business Name): TRINITY HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 04/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 E MAIN ST
ERIN TN
37061-4115
US

IV. Provider business mailing address

PO BOX 489 5001 E MAIN ST
ERIN TN
37061-0489
US

V. Phone/Fax

Practice location:
  • Phone: 931-289-4211
  • Fax: 931-289-4337
Mailing address:
  • Phone: 931-289-4211
  • Fax: 931-289-4158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number0000000055
License Number StateTN

VIII. Authorized Official

Name: SHANNON ALLISON
Title or Position: CFO
Credential:
Phone: 931-289-4211