Organization
LAUGHLIN MEMORIAL HOSPITAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LYNN KRUTAK (EVP/CFO)
(423) 302-3423
Entity
Organization
Contact information
Practice address
1420 TUSCULUM BLVD, GREENEVILLE, TN 37745-4279
(423) 787-5000
(423) 787-5009
Mailing address
311 PRINCETON RD STE 1, JOHNSON CITY, TN 37601-2026
(423) 787-5000
(423) 787-5009
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
0000000053
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0440025
—
TN
01
—
1000367
BLUE CROSS OF TENNESSEE
TN
Enumeration date
02/22/2006
Last updated
02/05/2018
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