Organization
PINELAKE REGIONAL HOSPITAL LLC
Active
Parent organization
PINELAKE REGIONAL HOSPITAL LLC
Other names
Jackson Purchase Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PINELAKE REGIONAL HOSPITAL LLC
Authorized official
MR. ROBERT SCOTT RAPLEE (PRESIDENT)
(615) 920-7000
Entity
Organization
Contact information
Practice address
1099 MEDICAL CENTER CIR, MAYFIELD, KY 42066-1159
(270) 251-4100
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-4536
(615) 920-7000
(615) 920-8913
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000061925
ANTHEM
—
Enumeration date
02/06/2008
Last updated
04/14/2014
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