Healthcare Provider Details

I. General information

NPI: 1932170750
Provider Name (Legal Business Name): SHELBYVILLE HOSPITAL COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 08/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2835 HWY 231 N
SHELBYVILLE TN
37160-2607
US

IV. Provider business mailing address

PO BOX 403621
ATLANTA GA
30384-3621
US

V. Phone/Fax

Practice location:
  • Phone: 931-685-5433
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number0000000002
License Number StateTN

VIII. Authorized Official

Name: PAULA M LALOR
Title or Position: DIRECTOR/DELEGATED OFFICIAL
Credential:
Phone: 615-925-4565