Provider Demographics
NPI:1164590386
Name:SAINT THOMAS RUTHERFORD HOSPITAL
Entity Type:Organization
Organization Name:SAINT THOMAS RUTHERFORD HOSPITAL
Other - Org Name:ASCENSION SAINT THOMAS RUTHERFORD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:BORLAND
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-396-4101
Mailing Address - Street 1:1700 MEDICAL CENTER PKWY
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2245
Mailing Address - Country:US
Mailing Address - Phone:615-396-4100
Mailing Address - Fax:312-462-6293
Practice Address - Street 1:1700 MEDICAL CENTER PKWY
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2245
Practice Address - Country:US
Practice Address - Phone:615-396-4100
Practice Address - Fax:312-462-6293
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINT THOMAS HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-04
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000100282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN440053Medicaid
TN440053Medicare Oscar/Certification