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General NPI Number Information
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NPI Number | 1528665452
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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 | 10/05/2020
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Last Update Date | 10/05/2020
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Provider Practice Location Address
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Address Line | 103 JV MANGUBAT DR
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City | WAYNESBORO
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State | TN
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Zip | 38485-2440
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Country | US
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Telephone | 952-653-2525
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Fax | 952-653-2540
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Provider Business Mailing Address
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Address Line | 103 JV MANGUBAT DR
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City | WAYNESBORO
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State | TN
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Zip | 38485-2440
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Country | US
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Telephone | 952-653-2525
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Fax | 952-653-2540
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | PAUL BRATTON BETZ
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Credential |
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Telephone | 205-759-7147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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