Provider Demographics
NPI:1992397152
Name:SAINT THOMAS RIVER PARK HOSPITAL, LLC
Entity Type:Organization
Organization Name:SAINT THOMAS RIVER PARK HOSPITAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF BUSINESS OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-290-7184
Mailing Address - Street 1:300 20TH AVE N STE 403
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5180
Mailing Address - Country:US
Mailing Address - Phone:615-289-3257
Mailing Address - Fax:
Practice Address - Street 1:140 VO TECH DR STE 4
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-1329
Practice Address - Country:US
Practice Address - Phone:931-474-1224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINT THOMAS RIVER PARK HOSPITAL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-09
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health