MEDICARE: HARDIN COUNTY GENERAL HOSPITAL

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	251E00000X	Home Health Agency	0000000137	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	41349	OTHER	TN	TENNCARE SELECT
2	8284	OTHER	TN	TLC
3	118384	OTHER	TN	UNISON HEALTH PLANS
4	41349	OTHER	TN	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1538166814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARDIN COUNTY GENERAL HOSPITAL

Provider Business Mailing Address
First Line	:	983 WAYNE RD
Second Line	:	STE A
City	:	SAVANNAH
State	:	TN
Zip	:	38372-2290
Country	:	US
Telephone Number	:	731-926-8215
Fax Number	:	731-926-8217

Provider Business Practice Location Address
First Line	:	983 WAYNE RD
Second Line	:	STE A
City	:	SAVANNAH
State	:	TN
Zip	:	38372-2290
Country	:	US
Telephone Number	:	731-926-8215
Fax Number	:	731-926-8217

Authorized Official
Title or Position	:	CEO
Name	:	MRS. CHARLOTTE BURNS
Credential	:	R.N.
Telephone Number	:	731-926-8121

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	07/02/2008

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Directions to “HARDIN COUNTY GENERAL HOSPITAL ” Practice Location

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