Healthcare Provider Details

I. General information

NPI: 1700955408
Provider Name (Legal Business Name): HENRY COUNTY GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 E WOOD ST
PARIS TN
38242-4188
US

IV. Provider business mailing address

301 TYSON AVE PO BOX 1030
PARIS TN
38242-4544
US

V. Phone/Fax

Practice location:
  • Phone: 731-644-7600
  • Fax: 731-644-9639
Mailing address:
  • Phone: 731-644-8590
  • Fax: 731-644-8587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0000000122
License Number StateTN

VIII. Authorized Official

Name: MRS. LISA CASTEEL
Title or Position: CFO
Credential:
Phone: 731-644-8475