Provider Demographics
NPI:1164033213
Name:HUMPHREYS COUNTY COMMUNITY HEALTH SERVICES INC
Entity Type:Organization
Organization Name:HUMPHREYS COUNTY COMMUNITY HEALTH SERVICES INC
Other - Org Name:ASCENSION SAINT THOMAS THREE RIVERS PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-296-0111
Mailing Address - Street 1:451 HIGHWAY 13 S
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:TN
Mailing Address - Zip Code:37185-2109
Mailing Address - Country:US
Mailing Address - Phone:931-296-0211
Mailing Address - Fax:931-296-0199
Practice Address - Street 1:451 HIGHWAY 13 S
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:TN
Practice Address - Zip Code:37185-2109
Practice Address - Country:US
Practice Address - Phone:931-296-0211
Practice Address - Fax:931-296-0199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-12
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health