Healthcare Provider Details

I. General information

NPI: 1699861005
Provider Name (Legal Business Name): WEST TENNESSEE HEALTHCARE HENRY COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 10/09/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 TYSON AVE
PARIS TN
38242-4544
US

IV. Provider business mailing address

301 TYSON AVENUE
PARIS TN
38242-4544
US

V. Phone/Fax

Practice location:
  • Phone: 731-642-1220
  • Fax: 731-644-8587
Mailing address:
  • Phone: 731-642-1220
  • Fax: 731-644-8584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number000000057
License Number StateTN

VIII. Authorized Official

Name: TINA PRESCOTT
Title or Position: INTERIM PRESIDENT AND CEO
Credential:
Phone: 731-541-6767