Healthcare Provider Details

I. General information

NPI: 1386551760
Provider Name (Legal Business Name): NORTH CAMPBELL COMMUNITY HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 HOSPITAL LN
JELLICO TN
37762-4400
US

IV. Provider business mailing address

200 W CHURCH ST
LEXINGTON TN
38351-2038
US

V. Phone/Fax

Practice location:
  • Phone: 731-968-3646
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: LARRY HENSON
Title or Position: RCD, AUTHORIZED OFFICIAL
Credential:
Phone: 336-944-6420