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General NPI Number Information
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NPI Number | 1578591756
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Entity Type | Organization
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Legal Business Name | MAURY REGIONAL HOSPITAL MARSHALL MEDICAL CENTER
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 1080 N ELLINGTON PKWY
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City | LEWISBURG
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State | TN
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Zip | 37091-2227
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Country | US
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Telephone | 931-359-6241
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Fax | 931-270-3627
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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 | 931-359-6241
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Fax | 931-270-3627
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Authorized Official
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Title or Position | VP FINANCE/IT
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Name | GREGORY A WHITLOCK
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Credential |
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Telephone | 931-540-4212
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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 | 0000000075
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License Number State | TN
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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 | 0000000075
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License Number State | TN
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