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General NPI Number Information
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NPI Number | 1548241953
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Entity Type | Organization
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Legal Business Name | CAMPBELL COUNTY HMA, LLC
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Dates
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Enumeration Date | 11/11/2005
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Last Update Date | 03/29/2021
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Provider Practice Location Address
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Address Line | 923 E CENTRAL AVE
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City | LA FOLLETTE
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State | TN
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Zip | 37766-2768
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Country | US
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Telephone | 423-907-1200
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Fax | 423-907-1189
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Provider Business Mailing Address
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Address Line | 923 E CENTRAL AVE
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City | LA FOLLETTE
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State | TN
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Zip | 37766-2768
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Country | US
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Telephone | 423-907-1200
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Fax | 423-907-1163
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Authorized Official
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Title or Position | DIRECTOR/DELEGATED OFFICIAL
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Name | PAULA M LALOR
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Credential |
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Telephone | 629-215-3953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 0000000008
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License Number State | TN
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