Provider Demographics
NPI:1003518929
Name:ERLANGER HEALTH
Entity Type:Organization
Organization Name:ERLANGER HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO, EVP
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEJACO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-778-4712
Mailing Address - Street 1:136 WHEELERTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37367-5247
Mailing Address - Country:US
Mailing Address - Phone:423-447-7784
Mailing Address - Fax:423-778-4833
Practice Address - Street 1:136 WHEELERTOWN AVE
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37367-5247
Practice Address - Country:US
Practice Address - Phone:423-447-7784
Practice Address - Fax:423-778-4833
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ERLANGER HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health