Provider Demographics
NPI:1639123615
Name:HTI MEMORIAL HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:HTI MEMORIAL HOSPITAL CORPORATION
Other - Org Name:TRISTAR SKYLINE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-769-7100
Mailing Address - Street 1:3441 DICKERSON PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-2539
Mailing Address - Country:US
Mailing Address - Phone:615-769-2000
Mailing Address - Fax:615-769-7102
Practice Address - Street 1:3441 DICKERSON PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2539
Practice Address - Country:US
Practice Address - Phone:615-769-2000
Practice Address - Fax:615-769-7102
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HTI MEMORIAL HOSPITAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-22
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
44T006Medicare Oscar/Certification