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General NPI Number Information
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NPI Number | 1669876520
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Entity Type | Organization
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Legal Business Name | MARTIN HEALTH
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Dates
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Enumeration Date | 10/21/2014
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 1135 BROADWAY STREET
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City | SOUTH FULTON
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State | TN
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Zip | 38257-2835
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Country | US
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Telephone | 731-479-2606
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Fax | 731-479-2610
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Provider Business Mailing Address
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Address Line | 1135 BROADWAY STREET
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City | SOUTH FULTON
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State | TN
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Zip | 38257-2835
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Country | US
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Telephone | 731-479-2606
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Fax | 731-479-2610
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MS. TINA PRESCOTT
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Credential |
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Telephone | 731-541-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 0000000126
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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