Organization
PROGRESSIVE HEALTH OF JELLICO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT Q WHITWELL (CEO)
(662) 701-9346
Entity
Organization
Contact information
Practice address
188 HOSPITAL LN, JELLICO, TN 37762-4400
(423) 455-0245
Mailing address
188 HOSPITAL LN, JELLICO, TN 37762-4400
(423) 455-0245
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
—
—
282NC0060X
Critical Access Hospital
Primary
—
—
Other
Enumeration date
02/20/2024
Last updated
03/01/2024
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