=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528976271
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SAINT THOMAS RIVER PARK HOSPITAL LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/01/2026
-----------------------------------------------------
Last Update Date | 09/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 518 W MAIN ST STE A
-----------------------------------------------------
City | SMITHVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37166-1100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-215-5240
-----------------------------------------------------
Fax | 615-278-1326
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 300 20TH AVE N STE 403
-----------------------------------------------------
City | NASHVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37203-5180
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-284-4088
-----------------------------------------------------
Fax | 615-284-7501
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | REGIONAL DIRECTOR OF OPERATIONS
-----------------------------------------------------
Name | CANDACE GARRETT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 615-290-7184
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR1300X
-----------------------------------------------------
Taxonomy Name | Rural Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------