Provider Demographics
NPI:1710905609
Name:TROUSDALE MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:TROUSDALE MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WILHOITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-328-6695
Mailing Address - Street 1:555 HARTSVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-2400
Mailing Address - Country:US
Mailing Address - Phone:615-328-6695
Mailing Address - Fax:615-328-6698
Practice Address - Street 1:500 CHURCH ST
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37074-1744
Practice Address - Country:US
Practice Address - Phone:615-374-2221
Practice Address - Fax:615-374-2936
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TROUSDALE MEDICAL CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-18
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000118282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0160074Medicaid
TN0441301Medicaid
TN166551100OtherUS DEPT OF LABOR
TN309040OtherCSA MID & UPPER CUMBERLND
KY50003046OtherKY MEDICAID PASSPORT HLTH
TN0410430OtherHEALTH SPRINGS
5345219OtherAETNA PPO
0545006OtherAETNA HMO
5000403OtherUNITED HEALTHCARE
TN3143773OtherTENNCARE SELECT
TN320051OtherMEDICARE ID-TYPE UNSPECIFIED
TNA3707401OtherTENNCARE AMERI CHOICE
TN3143773OtherBLUE CROSS
TN3147773OtherTENNCARE BLUE CROSS
KY50003046OtherKY MEDICAID PASSPORT HLTH
5000403OtherUNITED HEALTHCARE
KY0160074Medicaid
TN320051OtherMEDICARE ID-TYPE UNSPECIFIED