Provider Demographics
NPI:1235387044
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
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:931-296-4203
Mailing Address - Fax:931-296-4561
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:931-296-4203
Practice Address - Fax:931-296-4561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000036282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN441303Medicare PIN