Organization
MARTIN HEALTH
Active
Other names
West Tennessee Medical Group Hillview South Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TINA PRESCOTT (PRESIDENT AND CEO)
(731) 541-5000
Entity
Organization
Contact information
Practice address
1135 BROADWAY STREET, SOUTH FULTON, TN 38257-2835
(731) 479-2606
(731) 479-2610
Mailing address
1135 BROADWAY STREET, SOUTH FULTON, TN 38257-2835
(731) 479-2606
(731) 479-2610
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
0000000126
TN
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044-3449
—
TN
05
—
Q012738
—
TN
Enumeration date
10/21/2014
Last updated
10/14/2024
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