Provider Demographics
NPI:1962449926
Name:HENDERSONVILLE HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:HENDERSONVILLE HOSPITAL CORPORATION
Other - Org Name:TRISTAR HENDERSONVILLE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-338-1100
Mailing Address - Street 1:1 PARK PLZ
Mailing Address - Street 2:REGULATORY COMPLIANCE SUPPORT, BLDG. 2-3 W
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-6527
Mailing Address - Country:US
Mailing Address - Phone:615-886-5650
Mailing Address - Fax:615-264-4281
Practice Address - Street 1:355 NEW SHACKLE ISLAND RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2300
Practice Address - Country:US
Practice Address - Phone:615-338-1000
Practice Address - Fax:615-264-4281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI30-4674471Medicaid