Organization
JACKSON TENNESSEE HOSPITAL COMPANY LLC
Active
Other names
Tennova Healthcare-Regional Jackson
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA M LALOR (DIRECTOR/DELEGATED OFFICIAL)
(615) 925-4565
Entity
Organization
Contact information
Practice address
367 HOSPITAL BLVD, JACKSON, TN 38305-2080
(731) 661-2000
Mailing address
367 HOSPITAL BLVD, JACKSON, TN 38305-2080
(731) 661-2000
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
0000000079
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0440189
—
TN
05
—
136770
—
TN
05
—
25834
—
TN
01
—
4048506
BCBS
—
05
—
440008
—
TN
Enumeration date
01/30/2006
Last updated
03/13/2018
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