Provider Demographics
NPI:1962034272
Name:LAUDERDALE COMMUNITY HOSPITAL LLC
Entity Type:Organization
Organization Name:LAUDERDALE COMMUNITY HOSPITAL LLC
Other - Org Name:LAUDERDALE COMMUNITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:DARREL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-527-1234
Mailing Address - Street 1:326 ASBURY AVE
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:TN
Mailing Address - Zip Code:38063-5577
Mailing Address - Country:US
Mailing Address - Phone:731-221-2200
Mailing Address - Fax:731-221-2499
Practice Address - Street 1:340 ASBURY AVE
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:TN
Practice Address - Zip Code:38063-5577
Practice Address - Country:US
Practice Address - Phone:731-221-2200
Practice Address - Fax:731-221-2499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty