Provider Demographics
NPI:1538114434
Name:HENDERSONVILLE HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:HENDERSONVILLE HOSPITAL CORPORATION
Other - Org Name:TRISTAR HENDERSONVILLE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-338-1100
Mailing Address - Street 1:355 NEW SHACKLE ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-2300
Mailing Address - Country:US
Mailing Address - Phone:615-338-1000
Mailing Address - Fax:615-264-4281
Practice Address - Street 1:355 NEW SHACKLE ISLAND RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2300
Practice Address - Country:US
Practice Address - Phone:615-338-1000
Practice Address - Fax:615-264-4281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
1000121OtherBLUE CROSS
IA0552273Medicaid
OH0832344Medicaid
FL908322700Medicaid
GA000787806XMedicaid
KY01621499Medicaid
TN0440194Medicaid
IN200462150AMedicaid
WA3026333Medicaid
KS511100Medicaid
MO016114506Medicaid
MN023982800Medicaid
TX072858601Medicaid
AR145257105Medicaid
LA1702528Medicaid
OK200068190AMedicaid
MI40-4674462Medicaid
NC4400194Medicaid
ALHEN0194NMedicaid
0401001OtherHEALTHSPRING
OR269671Medicaid
5000040OtherUNITED HEALTHCARE
AZ835928Medicaid
NE10025086300Medicaid
TX072858601Medicaid
ALHEN0194NMedicaid