Basic Information
| Provider Information | |||||||||
| NPI: | 1962725242 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CAH ACQUISITION COMPANY 11 LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | LAUDERDALE COMMUNITY HOSPITAL | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 326 ASBURY AVE | ||||||||
| Address2: | |||||||||
| City: | RIPLEY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 380635577 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7312212200 | ||||||||
| FaxNumber: | 7312212499 | ||||||||
| Practice Location | |||||||||
| Address1: | 326 ASBURY AVE | ||||||||
| Address2: | |||||||||
| City: | RIPLEY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 38063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7312212200 | ||||||||
| FaxNumber: | 7312212499 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2010 | ||||||||
| LastUpdateDate: | 07/16/2018 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | LAYFIELD | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | G | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 7312212200 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | CAH ACQUISITION COMPANY 11 LLC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 275N00000X | Y | Hospital Units | Medicare Defined Swing Bed Unit |
No ID Information.