Provider Demographics
NPI:1801960315
Name:CUMBERLAND RIVER HOSPITAL INC
Entity type:Organization
Organization Name:CUMBERLAND RIVER HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:STRONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-243-3581
Mailing Address - Street 1:100 OLD JEFFERSON STREET
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TN
Mailing Address - Zip Code:38551-4040
Mailing Address - Country:US
Mailing Address - Phone:931-243-3581
Mailing Address - Fax:931-243-5219
Practice Address - Street 1:100 OLD JEFFERSON STREET
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TN
Practice Address - Zip Code:38551-4040
Practice Address - Country:US
Practice Address - Phone:931-243-3581
Practice Address - Fax:931-243-5219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15275N00000X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4141267Medicaid
TN5534Medicaid
TNA3855100Medicaid
TN044U141Medicaid
199752800OtherDEPT OF LABOR
TN1000134OtherBCBS
TN1000134Medicaid
TN0440141Medicaid
0713454OtherCIGNA
IN100034800Medicaid
TN4139416Medicaid
TN1000134Medicaid
TN5534Medicaid
TN44Z319Medicare PIN
TN44U141Medicare Oscar/Certification