Organization
NORTHCREST MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL K DAVIS (CEO)
(615) 384-2411
Entity
Organization
Contact information
Practice address
100 NORTHCREST DR, SPRINGFIELD, TN 37172-3927
(615) 384-1571
(615) 382-5776
Mailing address
PO BOX 305172 DEPT 97, NASHVILLE, TN 37230-5172
(615) 384-1571
(615) 382-5776
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
0000000099
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000141
BLUE CROSS ID NUMBER
TN
01
—
440065
OSCAR/MEDICARE
TN
Enumeration date
10/04/2006
Last updated
12/20/2019
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