Provider Demographics
NPI:1447403894
Name:PATIENTS CHOICE MEDICAL CENTER OF ERIN, TENNESSEE, LLC
Entity Type:Organization
Organization Name:PATIENTS CHOICE MEDICAL CENTER OF ERIN, TENNESSEE, LLC
Other - Org Name:PATIENTS CHOICE SWING BED UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELSTON
Authorized Official - Middle Name:C
Authorized Official - Last Name:KEMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-840-0196
Mailing Address - Street 1:PO BOX 489
Mailing Address - Street 2:
Mailing Address - City:ERIN
Mailing Address - State:TN
Mailing Address - Zip Code:37061-0489
Mailing Address - Country:US
Mailing Address - Phone:931-289-4211
Mailing Address - Fax:931-289-4337
Practice Address - Street 1:5001 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ERIN
Practice Address - State:TN
Practice Address - Zip Code:37061-4115
Practice Address - Country:US
Practice Address - Phone:931-289-4211
Practice Address - Fax:931-289-4337
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RURAL HEALTHCARE DEVELOPERS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
44Z312Medicare PIN