Provider Demographics
NPI:1548398746
Name:HUMBOLDT GENERAL HOSPITAL
Entity Type:Organization
Organization Name:HUMBOLDT GENERAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:DR
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:731-784-0353
Mailing Address - Street 1:3525 CHERE CAROL RD
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:TN
Mailing Address - Zip Code:38343-3638
Mailing Address - Country:US
Mailing Address - Phone:731-784-0353
Mailing Address - Fax:731-784-0310
Practice Address - Street 1:3525 CHERE CAROL RD
Practice Address - Street 2:
Practice Address - City:HUMBOLDT
Practice Address - State:TN
Practice Address - Zip Code:38343-3638
Practice Address - Country:US
Practice Address - Phone:731-784-0353
Practice Address - Fax:731-784-0310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20503336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy