MEDICARE: PATIENTS CHOICE MEDICAL CENTER OF ERIN, TENNESSEE, 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
1	282NC0060X	Critical Access Hospital

General Provider Information

NPI Number	:	1851544282
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATIENTS CHOICE MEDICAL CENTER OF ERIN, TENNESSEE, LLC

Provider Business Mailing Address
First Line	:	PO BOX 489
Second Line	:
City	:	ERIN
State	:	TN
Zip	:	37061-0489
Country	:	US
Telephone Number	:	931-289-4211
Fax Number	:	931-289-4337

Provider Business Practice Location Address
First Line	:	5001 E MAIN ST
Second Line	:
City	:	ERIN
State	:	TN
Zip	:	37061-4115
Country	:	US
Telephone Number	:	931-289-4211
Fax Number	:	931-289-4337

Authorized Official
Title or Position	:	CEO
Name	:	ELSTON C KEMP
Credential	:
Telephone Number	:	662-840-0196

Provider Enumeration Date	:	10/29/2008
Last Update Date	:	08/29/2012

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