Organization
COFFEE MEDICAL GROUP LLC
Active
Other names
United Regional Medical Center Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY B HOPKINS (BUSINESS OFFICE MANAGER)
(931) 461-3425
Entity
Organization
Contact information
Practice address
1001 MCARTHUR DRIVE, MANCHESTER, TN 37355
(931) 728-3586
(931) 723-0781
Mailing address
1001 MCARTHUR DRIVE, MANCHESTER, TN 37355
(931) 728-3586
(931) 723-0781
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
7440354
TN
314000000X
Skilled Nursing Facility
Primary
445383
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0445383
—
TN
01
—
4039933
BCBS
TN
05
—
7440354
—
TN
Enumeration date
10/07/2006
Last updated
06/20/2008
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