MEDICARE: RUSH HOSPITAL/BUTLER, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1013355106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUSH HOSPITAL/BUTLER, INC

Provider Business Mailing Address
First Line	:	DEPT 3022, P.O. BOX 1000
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38148-3022
Country	:	US
Telephone Number	:	601-213-3010
Fax Number	:	601-213-3011

Provider Business Practice Location Address
First Line	:	1404 E PUSHMATAHA ST
Second Line	:
City	:	BUTLER
State	:	AL
Zip	:	36904-2728
Country	:	US
Telephone Number	:	205-459-4488
Fax Number	:	205-459-3010

Authorized Official
Title or Position	:	REGIONAL CEO
Name	:	DON LARKIN KENNEDY
Credential	:
Telephone Number	:	601-703-9614

Provider Enumeration Date	:	06/11/2013
Last Update Date	:	04/26/2023

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