Provider Demographics
NPI:1033187760
Name:COLUMBIA REGIONAL MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:COLUMBIA REGIONAL MEDICAL CENTER, LLC
Other - Org Name:CORE PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:O
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-388-9706
Mailing Address - Street 1:1114 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-1810
Mailing Address - Country:US
Mailing Address - Phone:931-388-9706
Mailing Address - Fax:931-490-1062
Practice Address - Street 1:1114 W 7TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-1810
Practice Address - Country:US
Practice Address - Phone:931-388-9706
Practice Address - Fax:931-490-1062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Not Answered208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty