# CROCKETT HOSPITAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southern Tennessee Regional Health System Lawrenceburg
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114003175
- **Authorized official:** TERRANCE DILLON (ASSISTANT SECRETARY)
- **Authorized official phone:** (502) 596-7220

## Contact information

- **Practice address:** 1607 S LOCUST AVE, LAWRENCEBURG, TN 38464-4011
- **Practice address phone:** (931) 762-6571
- **Practice address fax:** (931) 766-3339
- **Mailing address:** 330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-4536
- **Mailing address phone:** (615) 920-7000
- **Mailing address fax:** (615) 920-8913

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282NR1301X | Rural Acute Care Hospital | 0000000087 | TN | Yes |

## Other

- **Enumeration date:** 10/31/2006
- **Last updated:** 04/26/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000171091X | — | GA |
| 05 | — | 0440175 | — | TN |
| 05 | — | 09400008 | — | MS |
| 05 | — | 1762067 | — | LA |
| 05 | — | HOS0175N | — | AL |