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General NPI Number Information
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NPI Number | 1245275254
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Entity Type | Organization
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Legal Business Name | SAINT THOMAS HICKMAN HOSPITAL
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 08/11/2020
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Provider Practice Location Address
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Address Line | 135 E SWAN ST
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City | CENTERVILLE
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State | TN
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Zip | 37033-1417
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Country | US
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Telephone | 931-729-4271
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Fax | 931-729-0174
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Provider Business Mailing Address
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Address Line | 135 E SWAN ST
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City | CENTERVILLE
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State | TN
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Zip | 37033-1417
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Country | US
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Telephone | 931-729-4271
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Fax | 931-729-0174
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | MR. KEVIN CAMPBELL
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Credential |
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Telephone | 931-729-6790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 0000000056
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License Number State | TN
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