Provider Demographics
NPI:1548788458
Name:SHELBYVILLE HOSPITAL COMPANY LLC
Entity Type:Organization
Organization Name:SHELBYVILLE HOSPITAL COMPANY LLC
Other - Org Name:TENNOVA URGENT CARE-SHELBYVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERI
Authorized Official - Middle Name:SUZETTE
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7463
Mailing Address - Street 1:1612 N MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-2392
Mailing Address - Country:US
Mailing Address - Phone:931-680-8910
Mailing Address - Fax:931-685-4158
Practice Address - Street 1:1612 N MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-2392
Practice Address - Country:US
Practice Address - Phone:931-680-8910
Practice Address - Fax:931-685-4158
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHELBYVILLE HOSPITAL COMPANY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000002261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health