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General NPI Number Information
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NPI Number | 1669316204
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Entity Type | Organization
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Legal Business Name | JELLICO COMMUNITY HOSPITAL LLC
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Dates
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Enumeration Date | 04/15/2026
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Last Update Date | 04/15/2026
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Provider Practice Location Address
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Address Line | 188 HOSPITAL LN
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City | JELLICO
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State | TN
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Zip | 37762-4400
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Country | US
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Telephone | 814-341-5839
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Fax |
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Provider Business Mailing Address
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Address Line | 108 CENTRAL AVE E
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City | JAMESTOWN
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State | TN
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Zip | 38556-4106
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Country | US
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Telephone | 931-787-0787
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | TIMOTHY J REEVES
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Credential | LNHA
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Telephone | 814-341-5839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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