Healthcare Provider Details

I. General information

NPI: 1538667035
Provider Name (Legal Business Name): CARTHAGE HOSPITAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2018
Last Update Date: 10/01/2023
Certification Date: 10/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 COTTAGE RD
CARTHAGE TX
75633-1466
US

IV. Provider business mailing address

340 SEVEN SPRINGS WAY STE 100
BRENTWOOD TN
37027-5697
US

V. Phone/Fax

Practice location:
  • Phone: 903-693-6626
  • Fax: 903-694-4622
Mailing address:
  • Phone: 615-296-3000
  • Fax: 615-296-6227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: STEPHEN C PETROVICH
Title or Position: EVP
Credential:
Phone: 615-296-3000