Provider Demographics
NPI:1265051577
Name:MAURY REGIONAL HOSPITAL MARSHALL MEDICAL CENTER
Entity type:Organization
Organization Name:MAURY REGIONAL HOSPITAL MARSHALL MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRINKELY
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:931-540-4212
Mailing Address - Street 1:PO BOX 100054
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30348-0054
Mailing Address - Country:US
Mailing Address - Phone:931-379-5821
Mailing Address - Fax:931-379-5867
Practice Address - Street 1:200 S CROSS BRIDGES RD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:TN
Practice Address - Zip Code:38474-1714
Practice Address - Country:US
Practice Address - Phone:931-379-5821
Practice Address - Fax:931-379-5867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-16
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health