Healthcare Provider Details

I. General information

NPI: 1619185428
Provider Name (Legal Business Name): FRANK T RUTHERFORD MEMORIAL HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 04/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 LAFAYETTE RD
RED BOILING SPRINGS TN
37150-2021
US

IV. Provider business mailing address

555 HARTSVILLE PIKE
GALLATIN TN
37066-2400
US

V. Phone/Fax

Practice location:
  • Phone: 615-699-4035
  • Fax:
Mailing address:
  • Phone: 615-328-6695
  • Fax: 615-328-6698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number0000000129
License Number StateTN

VIII. Authorized Official

Name: MR. LYNN NORVELL
Title or Position: CFO
Credential:
Phone: 615-328-6695