# JELLICO REGIONAL HOSPITAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** JRH Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790563781
- **Authorized official:** DR. KIRNJOT SINGH MD (PRESIDENT)
- **Authorized official phone:** (219) 228-4355

## Contact information

- **Practice address:** 188 HOSPITAL LN STE 100, JELLICO, TN 37762-4400
- **Practice address phone:** (423) 933-1355
- **Practice address fax:** (423) 933-1348
- **Mailing address:** 10996 FOUR SEASONS PL STE 100C, CROWN POINT, IN 46307-7762
- **Mailing address phone:** (219) 228-1021

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/20/2023
- **Last updated:** 10/26/2023