Provider Demographics
NPI:1609187715
Name:SMITH COUNTY MEMORIAL HOSPITAL LLC
Entity Type:Organization
Organization Name:SMITH COUNTY MEMORIAL HOSPITAL LLC
Other - Org Name:RIVERVIEW REGIONAL MEDICAL CENTER NORTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:RAPLEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-372-8500
Mailing Address - Street 1:103 POWELL CT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5079
Mailing Address - Country:US
Mailing Address - Phone:615-372-8500
Mailing Address - Fax:615-372-8572
Practice Address - Street 1:158 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:TN
Practice Address - Zip Code:37030-1083
Practice Address - Country:US
Practice Address - Phone:615-735-1560
Practice Address - Fax:615-735-5143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN44U168Medicare Oscar/Certification