Basic Information
| Provider Information | |||||||||
| NPI: | 1891986162 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LAFOLLETTE COMM HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 905 E CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | LA FOLLETTE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 377662768 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4239071600 | ||||||||
| FaxNumber: | 4239071647 | ||||||||
| Practice Location | |||||||||
| Address1: | 905 E CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | LA FOLLETTE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 377662768 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4239071600 | ||||||||
| FaxNumber: | 4239071647 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2007 | ||||||||
| LastUpdateDate: | 09/06/2007 | ||||||||
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| AuthorizedOfficialLastName: | WATSON | ||||||||
| AuthorizedOfficialFirstName: | HERBERT | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 4239071600 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.