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NPI Code Detail

MEDICARE: CLEVELAND TENNESSEE HOSPITAL COMPANY LLC

MEDICARE: CLEVELAND TENNESSEE HOSPITAL COMPANY LLC
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
1282N00000XGeneral Acute Care Hospital0000000006TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25000072OTHERUNITED HEALTHCARE
30140006296OTHERHEALTHSOURCE
41000017OTHERBCBS
501CCHTNOTHERCOMP HEALTH
6030433100OTHERBLACK LUNG
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8A3731201OTHERJOHN DEERE
9MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790756203
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLEVELAND TENNESSEE HOSPITAL COMPANY LLC
Provider Business Mailing Address
First Line : PO BOX 198029
Second Line :
City : ATLANTA
State : GA
Zip : 30384-8029
Country : US
Telephone Number : 423-559-6000
Fax Number : 423-559-6653
Provider Business Practice Location Address
First Line : 2305 CHAMBLISS AVE NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-3847
Country : US
Telephone Number : 423-559-6000
Fax Number : 423-559-6653
Authorized Official
Title or Position : DIRECTOR/DELEGATED OFFICIAL
Name : PAULA M LALOR
Credential :
Telephone Number : 629-215-3953
Provider Enumeration Date : 02/01/2006
Last Update Date : 03/29/2021

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Directions to “CLEVELAND TENNESSEE HOSPITAL COMPANY LLC ” Practice Location

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