Provider Demographics
NPI:1659347920
Name:CAMDEN GENERAL HOSPITAL, INC.
Entity Type:Organization
Organization Name:CAMDEN GENERAL HOSPITAL, INC.
Other - Org Name:WEST TENNESSEE HEALTHCARE CAMDEN HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-541-5000
Mailing Address - Street 1:175 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:TN
Mailing Address - Zip Code:38320-1617
Mailing Address - Country:US
Mailing Address - Phone:731-584-0109
Mailing Address - Fax:731-584-0124
Practice Address - Street 1:175 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:TN
Practice Address - Zip Code:38320-1617
Practice Address - Country:US
Practice Address - Phone:731-584-0109
Practice Address - Fax:731-584-0124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-27
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000000003282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0441316Medicaid
TN0441316Medicaid