Organization
HMA FENTRESS COUNTY GENERAL HOSPITAL LLC
Active
Other names
Tennova Healthcare-Jamestown
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA M LALOR (DIRECTOR/DELEGATED OFFICIAL)
(615) 925-4565
Entity
Organization
Contact information
Practice address
436 CENTRAL AVE W, JAMESTOWN, TN 38556-3031
(931) 879-8171
Mailing address
436 CENTRAL AVE W, JAMESTOWN, TN 38556-3031
(931) 879-8171
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
0000000048
TN
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0440083
—
TN
01
—
1000102
BLUE CROSS
TN
Enumeration date
05/23/2006
Last updated
03/29/2018
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