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General NPI Number Information
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NPI Number | 1083683155
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Entity Type | Organization
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Legal Business Name | COOKEVILLE REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 1101 NEAL ST STE 103
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City | COOKEVILLE
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State | TN
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Zip | 38501-0917
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Country | US
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Telephone | 931-783-2941
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Fax | 931-783-2566
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Provider Business Mailing Address
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Address Line | 1101 NEAL ST STE 103
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City | COOKEVILLE
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State | TN
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Zip | 38501-0917
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Country | US
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Telephone | 931-528-5578
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Fax | 931-783-2566
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Authorized Official
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Title or Position | CEO
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Name | MARILYN C KEY
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Credential |
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Telephone | 931-783-2481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 0000000197
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License Number State | TN
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