Basic Information
Provider Information
NPI: 1386088326
EntityType: 2
ReplacementNPI:  
OrganizationName: RHN SCOTT MEMORIAL HOSPITAL LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: SCOTT MEMORIAL HOSPITAL
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 330 SEVEN SPRINGS WAY
Address2:  
City: BRENTWOOD
State: TN
PostalCode: 370275079
CountryCode: US
TelephoneNumber: 6159207000
FaxNumber: 6159208987
Practice Location
Address1: 1451 N GARDNER ST
Address2:  
City: SCOTTSBURG
State: IN
PostalCode: 471707751
CountryCode: US
TelephoneNumber: 8127528500
FaxNumber: 8127525884
Other Information
ProviderEnumerationDate: 04/22/2013
LastUpdateDate: 04/26/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: DILLON
AuthorizedOfficialFirstName: TERRANCE
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: ASSISTANT SECRETARY
AuthorizedOfficialTelephone: 5025967220
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: RHN SCOTT MEMORIAL HOSPITAL LLC
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/26/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
275N00000X  Y Hospital UnitsMedicare Defined Swing Bed Unit 

No ID Information.


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