Provider Demographics
NPI:1568537348
Name:CUMBERLAND RIVER HOSPITAL INC
Entity Type:Organization
Organization Name:CUMBERLAND RIVER HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:STRONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-243-3581
Mailing Address - Street 1:100 OLD JEFFERSON ST
Mailing Address - Street 2:PO BOX 427
Mailing Address - City:CELINA
Mailing Address - State:TN
Mailing Address - Zip Code:38551-4040
Mailing Address - Country:US
Mailing Address - Phone:931-243-3581
Mailing Address - Fax:931-243-5219
Practice Address - Street 1:100 OLD JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TN
Practice Address - Zip Code:38551-4040
Practice Address - Country:US
Practice Address - Phone:931-243-3581
Practice Address - Fax:931-243-5219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15146N00000X, 282N00000X, 282NC0060X
207P00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical AccessGroup - Multi-Specialty
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No282N00000XHospitalsGeneral Acute Care Hospital
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0440141Medicaid
TN1000134Medicaid
TN4141050OtherBCBS GROUP #
TNA3855100Medicaid
TN1509296Medicaid
IN200856370AMedicaid
TN4139416Medicaid
KYK65939910Medicaid
0713454OtherCIGNA
TN4139416OtherNEW BCBS #
TN4141267Medicaid
199752800OtherDEPARTMENT OF LABOR
TN5534Medicaid
KY7100019900Medicaid
TN1000134OtherBCBS
TN1000134Medicaid
KY7100019900Medicaid
TN103G704239Medicare PIN
IN200856370AMedicaid