Provider Demographics
NPI:1952803892
Name:JAMESTOWN TN MEDICAL CENTER INC
Entity Type:Organization
Organization Name:JAMESTOWN TN MEDICAL CENTER INC
Other - Org Name:JAMESTOWN REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOM
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:BOM
Authorized Official - Phone:931-879-3339
Mailing Address - Street 1:436 CENTRAL AVE W
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38556-3031
Mailing Address - Country:US
Mailing Address - Phone:931-879-8171
Mailing Address - Fax:931-879-3181
Practice Address - Street 1:436 CENTRAL AVE W
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:TN
Practice Address - Zip Code:38556-3031
Practice Address - Country:US
Practice Address - Phone:931-879-8171
Practice Address - Fax:931-879-3181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-07
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN000440083Medicaid