Provider Demographics
NPI:1467408781
Name:SOUTHERN TENNESSEE MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:SOUTHERN TENNESSEE MEDICAL CENTER LLC
Other - Org Name:SOUTHERN TENNESSEE REGIONAL HEALTH SYSTEM WINCHESTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-920-7000
Mailing Address - Street 1:330 SEVEN SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4536
Mailing Address - Country:US
Mailing Address - Phone:615-920-7000
Mailing Address - Fax:615-920-8913
Practice Address - Street 1:185 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-2404
Practice Address - Country:US
Practice Address - Phone:931-967-8200
Practice Address - Fax:931-962-8836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000139282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
031051900OtherBLACK LUNG
TN1000048OtherBLUE SELECT
AL010069OtherBLUE CROSS OF ALABLAMA
TN1000048OtherTNCARE BLUE CARE
TN0440058Medicaid
TN1000048OtherBLUE CROSS OF TN
TNA3739800Medicaid
TN100029904Medicaid
AL010069OtherBLUE CROSS OF ALABLAMA