Provider Demographics
NPI:1467495796
Name:TCMC MADISON-PORTLAND, INC.
Entity type:Organization
Organization Name:TCMC MADISON-PORTLAND, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DENISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-769-7262
Mailing Address - Street 1:PO BOX 277464
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-7464
Mailing Address - Country:US
Mailing Address - Phone:615-865-0300
Mailing Address - Fax:615-860-6447
Practice Address - Street 1:500 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-5031
Practice Address - Country:US
Practice Address - Phone:615-865-0300
Practice Address - Fax:615-860-6447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5000106OtherUNITED HEALTH CARE
TN0440135OtherVANDERBILT HEALTH PLAN
TN1000151OtherBLUE CROSS
KY01620517Medicaid
2294609OtherAETNA
TN048278OtherVALUEOPTIONS
0701589OtherCIGNA 440
TN1000151OtherTNCARE SELECT
TN1000151OtherTNCARE SELECT