Organization
TAKOMA REGIONAL HOSPITAL INC
Active
Other names
Laughlin Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE EDWIN HILTON (EVP/CFO)
(423) 302-3467
Entity
Organization
Contact information
Practice address
801 E MCKEE ST, GREENEVILLE, TN 37743-6010
(423) 638-9226
(423) 638-1561
Mailing address
311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
(423) 638-9226
(423) 638-1561
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
620701119
TN
314000000X
Skilled Nursing Facility
620701119
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0125021
BLUE CROSS - BLUE SHIELD
TN
05
—
0445264
—
TN
01
—
0740620001
PALMETTO GOVERNMENT ADMIN
TN
05
—
7440545
—
TN
Enumeration date
07/01/2005
Last updated
04/17/2024
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