Organization
WYNDRIDGE HEALTH SYSTEMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY E COCHRAN (ADMINISTRATOR)
(931) 484-6129
Entity
Organization
Contact information
Practice address
456 WAYNE AVENUE, CROSSVILLE, TN 38555
(931) 484-6129
(931) 484-2685
Mailing address
456 WAYNE AVENUE, CROSSVILLE, TN 38555
(931) 484-6129
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0000000312
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454116
—
TN
01
—
4011143
BCBS
—
Enumeration date
10/12/2006
Last updated
09/21/2007
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