Provider Demographics
NPI:1720607021
Name:MAURY REGIONAL HOSPITAL MARSHALL MEDICAL CENTER
Entity Type:Organization
Organization Name:MAURY REGIONAL HOSPITAL MARSHALL MEDICAL CENTER
Other - Org Name:MRMG PLAZA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRINKLEY
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:931-540-4212
Mailing Address - Street 1:854 W JAMES M CAMPBELL BLVD STE 303
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4672
Mailing Address - Country:US
Mailing Address - Phone:931-388-9706
Mailing Address - Fax:931-490-1095
Practice Address - Street 1:854 W JAMES M CAMPBELL BLVD STE 403
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4659
Practice Address - Country:US
Practice Address - Phone:931-380-0075
Practice Address - Fax:931-388-7502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-16
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty