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General NPI Number Information
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NPI Number | 1881665396
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Entity Type | Organization
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Legal Business Name | MCKENZIE TENNESSEE HOSPITAL COMPANY LLC
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 03/14/2008
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Provider Practice Location Address
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Address Line | 161 HOSPITAL DR
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City | MC KENZIE
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State | TN
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Zip | 38201-1636
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Country | US
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Telephone | 731-352-5344
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 501092
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City | SAINT LOUIS
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State | MO
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Zip | 63150-1092
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SENIOR VP, GROUP OPERATIONS
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Name | WILLIAM HUSSEY
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Credential |
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Telephone | 888-373-9600
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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 | 0000000011
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License Number State | TN
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