Provider Demographics
NPI:1063660595
Name:HARDIN COUNTY REGIONAL HEALTH CENTER
Entity Type:Organization
Organization Name:HARDIN COUNTY REGIONAL HEALTH CENTER
Other - Org Name:LIFESPAN HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YAINIEH
Authorized Official - Middle Name:T
Authorized Official - Last Name:MCGINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-925-2300
Mailing Address - Street 1:PO BOX 655
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:TN
Mailing Address - Zip Code:38372-0655
Mailing Address - Country:US
Mailing Address - Phone:731-925-2300
Mailing Address - Fax:731-925-2157
Practice Address - Street 1:207 MAIN ST
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:TN
Practice Address - Zip Code:38425-5547
Practice Address - Country:US
Practice Address - Phone:931-676-3245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-09
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0441906Medicaid
441906Medicare Oscar/Certification