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General NPI Number Information
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NPI Number | 1447113873
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Entity Type | Organization
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Legal Business Name | MAURY REGIONAL HOSPITAL
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 3316 HIGHWAY 43 N STE 200
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City | ETHRIDGE
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State | TN
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Zip | 38456-2136
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Country | US
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Telephone | 931-244-6090
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100054
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City | ATLANTA
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State | GA
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Zip | 30348-0054
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | GREGORY A WHITLOCK
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Credential |
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Telephone | 931-540-4233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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