Provider Demographics
NPI:1780887679
Name:SAINT THOMAS RUTHERFORD HOSPITAL
Entity type:Organization
Organization Name:SAINT THOMAS RUTHERFORD HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNN
Authorized Official - Suffix:
Authorized Official - Credentials:MSO
Authorized Official - Phone:615-396-5004
Mailing Address - Street 1:301 N UNIVERSITY ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-3900
Mailing Address - Country:US
Mailing Address - Phone:615-396-5004
Mailing Address - Fax:615-396-5283
Practice Address - Street 1:301 N UNIVERSITY ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-3900
Practice Address - Country:US
Practice Address - Phone:615-396-5004
Practice Address - Fax:615-396-5283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center