Provider Demographics
NPI:1073216370
Name:ERLANGER HEALTH
Entity Type:Organization
Organization Name:ERLANGER HEALTH
Other - Org Name:BLEDSOE HOSPITAL SWINGBED
Other - Org Type:Other Name
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:423-778-7212
Mailing Address - Street 1:71 WHEELERTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37367-5246
Mailing Address - Country:US
Mailing Address - Phone:423-447-2112
Mailing Address - Fax:
Practice Address - Street 1:71 WHEELERTOWN AVE
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37367-5246
Practice Address - Country:US
Practice Address - Phone:423-447-2112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ERLANGER HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit