Provider Demographics
NPI:1497746721
Name:CUMBERLAND MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:CUMBERLAND MEDICAL CENTER, INC.
Other - Org Name:CMC MEDICAL EQUIPMENT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:MCMACKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-484-9511
Mailing Address - Street 1:591 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-5009
Mailing Address - Country:US
Mailing Address - Phone:931-484-8076
Mailing Address - Fax:931-484-2393
Practice Address - Street 1:591 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-5009
Practice Address - Country:US
Practice Address - Phone:931-484-8076
Practice Address - Fax:931-484-2393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000398332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3547142Medicaid
TN0293100002Medicare ID - Type Unspecified