Organization
CLARKSVILLE HEALTH SYSTEM GP
Active
Parent organization
CLARKSVILLE HEALTH SYSTEM GP
Other names
Gateway Health System
Organization subpart
Yes
Provider details
NPI number
Legal business name
CLARKSVILLE HEALTH SYSTEM GP
Authorized official
LAURIE HOLTSFORD (DIRECTOR OF BUSINESS OFFICE SUPPORT)
(615) 465-7000
Entity
Organization
Contact information
Practice address
1760 MADISON ST, CLARKSVILLE, TN 37043-4913
(931) 552-6622
(931) 551-1027
Mailing address
PO BOX 403765, ATLANTA, GA 30384-3765
(931) 552-6622
(931) 551-1027
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0000000623
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454419
—
TN
Enumeration date
06/06/2006
Last updated
03/07/2008
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